title: Heart-kidney biomarkers in patients undergoing cardiac stress testing.
abstract: We examined association of inducible myocardial perfusion defects with cardiorenal biomarkers, and of diminished left ventricular ejection fraction (LVEF) with kidney injury marker plasma neutrophil gelatinase-associated lipocalin (NGAL). Patients undergoing nuclear myocardial perfusion stress imaging were divided into 2 groups. Biomarkers were analyzed pre- and poststress testing. Compared to the patients in the low ischemia group (n = 16), the patients in the high ischemia group (n = 18) demonstrated a significantly greater rise in cardiac biomarkers plasma BNP, NT-proBNP and cTnI. Subjects were also categorized based on pre- or poststress test detectable plasma NGAL. With stress, the group with no detectable NGAL had a segmental defect score 4.2 compared to 8.2 (P = .06) in the detectable NGAL group, and 0.9 vs. 3.8 (P = .03) at rest. BNP rose with stress to a greater degree in patients with detectable NGAL (10.2 vs. 3.5 pg/mL, P = .03). LVEF at rest and with stress was significantly lower in the detectable NGAL group; 55.8 versus 65.0 (P = .03) and 55.1 vs. 63.8 (P = .04), respectively. Myocardial perfusion defects associate with biomarkers of cardiac stress, and detectable plasma NGAL with significantly lower LVEF, suggesting a specific heart-kidney link.
authors.affiliation: Division of Nephrology, Meilahti Hospital, HUCH, P.O. Box 340, 00029 Helsinki, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Haapio
authors.forename: Andrew A
authors.initials: AA
authors.lastname: House
authors.forename: Massimo
authors.initials: M
authors.lastname: de Cal
authors.forename: Dinna N
authors.initials: DN
authors.lastname: Cruz
authors.forename: Paolo
authors.initials: P
authors.lastname: Lentini
authors.forename: Davide
authors.initials: D
authors.lastname: Giavarina
authors.forename: Antonio
authors.initials: A
authors.lastname: Fortunato
authors.forename: Luigi
authors.initials: L
authors.lastname: Menghetti
authors.forename: Matteo
authors.initials: M
authors.lastname: Salgarello
authors.forename: Andrea
authors.initials: A
authors.lastname: Lupi
authors.forename: Giuliano
authors.initials: G
authors.lastname: Soffiati
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fontanelli
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Zanco
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco