title: Placental growth factor may predict increased left ventricular mass index in patients with mild to moderate chronic kidney disease--a prospective observational study.
abstract: BACKGROUND
  Placental growth factor [PlGF) is a cardiovascular (CV) risk marker, which is related to left ventricle hypertrophy (LVH) in animal models. Currently there are no data available regarding the possible relationship of PlGF and the development of LVH or diastolic dysfunction in patients with chronic kidney disease (CKD) and the relationship of PlGF to other CV risk factors in CKD patients. The aim of our study was to determine the possible association of PlGF and several other CV risk markers to echocardiographic parameters in CKD population.
  
  
  METHODS
  We prospectively examined selected laboratory (PlGF, fibroblast growth factor-23 -FGF23, vitamin D, parathyroid hormone, extracellular newly identified RAGE-binding protein - EN-RAGE, B-type natriuretic peptide - BNP) and echocardiographic parameters in 62 patients with CKD 2-4. Mean follow-up was 36 ±10 months. Laboratory and echocardiographic data were collected 2-3 times, at the shortest interval of 12 months apart. Multivariate regression analysis was used to detect independent correlations of variables.
  
  
  RESULTS
  Increased left ventricular mass index (LVMI, g/m2.7) was found in 29% patients with CKD 2-4, left ventricular (LV) diastolic dysfunction was detected in 74.1% patients (impaired LV relaxation in 43.5% patients and pseudonormal pattern in 30.6% patients). After 36 ± 10 months increased LVMI was found in 37.1% patients with CKD 2-4, LV diastolic dysfunction was detected in 75.8% patients (impaired LV relaxation in 43.5% patients and pseudonormal pattern in 32.3% patients). Following independent correlations were found: LVMI was related to PlGF, cholesterol, BNP, systolic blood pressure and serum creatinine. EN-RAGE correlated positively with left atrial diameter and inversely with E/A ratio. During the follow-up we found a significant increase in LVMI and left atrial diameter, whereas a significant decrease in LVEF was noted.
  
  
  CONCLUSIONS
  According to our data, PlGF is independently related to increased LV mass in CKD, whereas EN-RAGE is more likely related to diastolic dysfunction in this population.
authors.affiliation: Department of Nephrology, First Faculty of Medicine, Charles University, Prague, Czech Republic. mpeiskerova@seznam.cz
authors.forename: Martina
authors.initials: M
authors.lastname: Peiskerová
authors.forename: Marta
authors.initials: M
authors.lastname: Kalousová
authors.forename: Vilem
authors.initials: V
authors.lastname: Danzig
authors.forename: Blanka
authors.initials: B
authors.lastname: Míková
authors.forename: Magdalena
authors.initials: M
authors.lastname: Hodková
authors.forename: Eduard
authors.initials: E
authors.lastname: Němeček
authors.forename: Amjad
authors.initials: A
authors.lastname: Bani-Hani
authors.forename: David
authors.initials: D
authors.lastname: Ambrož
authors.forename: Hana
authors.initials: H
authors.lastname: Benáková
authors.forename: Ales
authors.initials: A
authors.lastname: Linhart
authors.forename: Tomas
authors.initials: T
authors.lastname: Zima
authors.forename: Vladimir
authors.initials: V
authors.lastname: Tesař
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D000089703:Fibroblast Growth Factor-23; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D000072483:Placenta Growth Factor; D011237:Predictive Value of Tests; D011257:Pregnancy Proteins / Q000097:blood*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D000072483:Placenta Growth Factor; D000089703:Fibroblast Growth Factor-23