Soluble e-selectin is an inverse and independent predictor of left ventricular wall thickness in end-stage renal disease patients.
BACKGROUND
E-selectin is a specific endothelial cell product involved in leukocyte recruitment on the endothelium, which is an important early step in the reparative process following vascular damage. In end-stage renal disease (ESRD), the relationship of E-selectin with left ventricular function has been so far neglected.


METHODS
We studied 237 patients on chronic dialysis (200 on hemodialysis, 37 on continuous ambulatory peritoneal dialysis) for at least 6 months, without clinical evidence of heart failure. On a mid-week non-dialysis day, fasting blood sampling and echocardiography were performed.


RESULTS
Left ventricular mass index (LVMI, corrected for height) was inversely related to E-selectin levels, increasing from 56.8 +/- 18.9 (>75th percentile E-selectin tertile) to 66.7 +/- 20.1 g/m(2.7) (<50th percentile E-selectin tertile) (p = 0.002). However, in multiple regression models, including traditional (age, sex, smoking, diabetes, systolic blood pressure, hemoglobin, albumin, previous cardiovascular events) and emerging (asymmetric dimethylarginine, interleukin-6) risk factors associated with ESRD, soluble E-selectin has proved to be a significant inverse and independent predictor of mean wall thickness, but not of LVMI.


CONCLUSIONS
This study demonstrates that soluble E-selectin is inversely associated with the muscular component of the left ventricle, thereby suggesting that the lack of such a reparative factor may be associated with cardiac remodeling in ESRD patients.
Division of Internal Medicine, Hypertension and Cardio-Renal Diseases Centre, Department of Internal Medicine and Systemic Diseases, University of Catania, c/o Ospedale Civile, Ragusa, Italy.
Benedetta
B
Stancanelli
Lorenzo S
LS
Malatino
Alessandro
A
Cataliotti
Ignazio
I
Bellanuova
Francesca
F
Mallamaci
Giovanni
G
Tripepi
Frank A
FA
Benedetto
Daniela
D
Leonardis
Pasquale
P
Fatuzzo
Francesco
F
Rapisarda
Carmine
C
Zoccali
D003430:Cross-Sectional Studies; D019040:E-Selectin / Q000097:blood* / Q000502:physiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D012307:Risk Factors; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*
D019040:E-Selectin