The relationship between pulse pressure and inflammation with left ventricular diastolic dysfunction in chronic kidney disease patients

Kenneth Yong, Trevor Mori, Gerard Chew, Lawrence J Beilin, Ian Puddey, Gerald Watts, Gursharan Dogra, Neil Boudville, Wai Lim

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Diastolic dysfunction (DD) is an important cause of cardiovascular disease (CVD) mortality in chronic kidney disease (CKD) patients. Non-traditional risk factors such as arterial stiffness and inflammation are implicated in the pathogenesis of DD in CKD patients.

AIM: To determine the association between inflammatory markers [interleukin(IL)-12, IL-18, highly sensitive C-reactive protein (hsCRP)] and non-invasive markers of arterial stiffness [24-hour pulse pressure (PP)] with DD in stage 3-4 CKD patients.

METHODS: We performed a sub-analysis of 78 non-diabetic stage 3-4 CKD subjects to determine the relationship between 24-hour PP, IL-12, IL-18 and hsCRP with DD.

RESULTS: DD was present in 38 subjects (49%). Subjects with DD were significantly older (61.0±1.9 vs 50.2±2.0years; p<0.001) and had higher 24-hour PP [48(95%CI 45, 52) vs 43(95%CI 41, 45)mmHg; p<0.005]. 24-hour PP was associated with DD (p=0.02) but this was no longer significant after adjustment for age (p=0.31). Serum IL-12, IL-18 and hsCRP levels were not significantly different between subjects with or without DD.

CONCLUSION: Asymptomatic subclinical DD was present in 50% of a cohort of stage 3-4 CKD patients but was not associated with IL-12, IL-18 or hsCRP. The association between 24-hour PP and DD was no longer apparent following adjustment for age but given the small sample size our findings will need to be explored in larger sized cohorts of individuals with moderate stage CKD. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)240-247
JournalInternal Medicine Journal
Volume49
Issue number2
DOIs
Publication statusPublished - 12 Feb 2019

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Left Ventricular Dysfunction
Chronic Renal Insufficiency
Interleukin-18
Interleukin-12
Blood Pressure
Inflammation
C-Reactive Protein
Vascular Stiffness
Arteritis
Sample Size
Cardiovascular Diseases
Mortality
Serum

Cite this

@article{2121b22d9fc14fd5be5a6bcfb8ed1a9e,
title = "The relationship between pulse pressure and inflammation with left ventricular diastolic dysfunction in chronic kidney disease patients",
abstract = "INTRODUCTION: Diastolic dysfunction (DD) is an important cause of cardiovascular disease (CVD) mortality in chronic kidney disease (CKD) patients. Non-traditional risk factors such as arterial stiffness and inflammation are implicated in the pathogenesis of DD in CKD patients.AIM: To determine the association between inflammatory markers [interleukin(IL)-12, IL-18, highly sensitive C-reactive protein (hsCRP)] and non-invasive markers of arterial stiffness [24-hour pulse pressure (PP)] with DD in stage 3-4 CKD patients.METHODS: We performed a sub-analysis of 78 non-diabetic stage 3-4 CKD subjects to determine the relationship between 24-hour PP, IL-12, IL-18 and hsCRP with DD.RESULTS: DD was present in 38 subjects (49{\%}). Subjects with DD were significantly older (61.0±1.9 vs 50.2±2.0years; p<0.001) and had higher 24-hour PP [48(95{\%}CI 45, 52) vs 43(95{\%}CI 41, 45)mmHg; p<0.005]. 24-hour PP was associated with DD (p=0.02) but this was no longer significant after adjustment for age (p=0.31). Serum IL-12, IL-18 and hsCRP levels were not significantly different between subjects with or without DD.CONCLUSION: Asymptomatic subclinical DD was present in 50{\%} of a cohort of stage 3-4 CKD patients but was not associated with IL-12, IL-18 or hsCRP. The association between 24-hour PP and DD was no longer apparent following adjustment for age but given the small sample size our findings will need to be explored in larger sized cohorts of individuals with moderate stage CKD. This article is protected by copyright. All rights reserved.",
author = "Kenneth Yong and Trevor Mori and Gerard Chew and Beilin, {Lawrence J} and Ian Puddey and Gerald Watts and Gursharan Dogra and Neil Boudville and Wai Lim",
note = "This article is protected by copyright. All rights reserved.",
year = "2019",
month = "2",
day = "12",
doi = "10.1111/imj.14037",
language = "English",
volume = "49",
pages = "240--247",
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The relationship between pulse pressure and inflammation with left ventricular diastolic dysfunction in chronic kidney disease patients. / Yong, Kenneth; Mori, Trevor; Chew, Gerard; Beilin, Lawrence J; Puddey, Ian; Watts, Gerald; Dogra, Gursharan; Boudville, Neil; Lim, Wai.

In: Internal Medicine Journal, Vol. 49, No. 2, 12.02.2019, p. 240-247.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The relationship between pulse pressure and inflammation with left ventricular diastolic dysfunction in chronic kidney disease patients

AU - Yong, Kenneth

AU - Mori, Trevor

AU - Chew, Gerard

AU - Beilin, Lawrence J

AU - Puddey, Ian

AU - Watts, Gerald

AU - Dogra, Gursharan

AU - Boudville, Neil

AU - Lim, Wai

N1 - This article is protected by copyright. All rights reserved.

PY - 2019/2/12

Y1 - 2019/2/12

N2 - INTRODUCTION: Diastolic dysfunction (DD) is an important cause of cardiovascular disease (CVD) mortality in chronic kidney disease (CKD) patients. Non-traditional risk factors such as arterial stiffness and inflammation are implicated in the pathogenesis of DD in CKD patients.AIM: To determine the association between inflammatory markers [interleukin(IL)-12, IL-18, highly sensitive C-reactive protein (hsCRP)] and non-invasive markers of arterial stiffness [24-hour pulse pressure (PP)] with DD in stage 3-4 CKD patients.METHODS: We performed a sub-analysis of 78 non-diabetic stage 3-4 CKD subjects to determine the relationship between 24-hour PP, IL-12, IL-18 and hsCRP with DD.RESULTS: DD was present in 38 subjects (49%). Subjects with DD were significantly older (61.0±1.9 vs 50.2±2.0years; p<0.001) and had higher 24-hour PP [48(95%CI 45, 52) vs 43(95%CI 41, 45)mmHg; p<0.005]. 24-hour PP was associated with DD (p=0.02) but this was no longer significant after adjustment for age (p=0.31). Serum IL-12, IL-18 and hsCRP levels were not significantly different between subjects with or without DD.CONCLUSION: Asymptomatic subclinical DD was present in 50% of a cohort of stage 3-4 CKD patients but was not associated with IL-12, IL-18 or hsCRP. The association between 24-hour PP and DD was no longer apparent following adjustment for age but given the small sample size our findings will need to be explored in larger sized cohorts of individuals with moderate stage CKD. This article is protected by copyright. All rights reserved.

AB - INTRODUCTION: Diastolic dysfunction (DD) is an important cause of cardiovascular disease (CVD) mortality in chronic kidney disease (CKD) patients. Non-traditional risk factors such as arterial stiffness and inflammation are implicated in the pathogenesis of DD in CKD patients.AIM: To determine the association between inflammatory markers [interleukin(IL)-12, IL-18, highly sensitive C-reactive protein (hsCRP)] and non-invasive markers of arterial stiffness [24-hour pulse pressure (PP)] with DD in stage 3-4 CKD patients.METHODS: We performed a sub-analysis of 78 non-diabetic stage 3-4 CKD subjects to determine the relationship between 24-hour PP, IL-12, IL-18 and hsCRP with DD.RESULTS: DD was present in 38 subjects (49%). Subjects with DD were significantly older (61.0±1.9 vs 50.2±2.0years; p<0.001) and had higher 24-hour PP [48(95%CI 45, 52) vs 43(95%CI 41, 45)mmHg; p<0.005]. 24-hour PP was associated with DD (p=0.02) but this was no longer significant after adjustment for age (p=0.31). Serum IL-12, IL-18 and hsCRP levels were not significantly different between subjects with or without DD.CONCLUSION: Asymptomatic subclinical DD was present in 50% of a cohort of stage 3-4 CKD patients but was not associated with IL-12, IL-18 or hsCRP. The association between 24-hour PP and DD was no longer apparent following adjustment for age but given the small sample size our findings will need to be explored in larger sized cohorts of individuals with moderate stage CKD. This article is protected by copyright. All rights reserved.

U2 - 10.1111/imj.14037

DO - 10.1111/imj.14037

M3 - Article

VL - 49

SP - 240

EP - 247

JO - Internal Medicine Journal (Print)

JF - Internal Medicine Journal (Print)

SN - 1444-0903

IS - 2

ER -