Association of circulating cardiac biomarkers with electrocardiographic abnormalities in chronic kidney disease

Alexander J. Kula*, Ronit Katz, Leila R. Zelnick, Elsayed Soliman, Alan Go, Michael Shlipak, Rajat Deo, Bonnie Ky, Ian Deboer, Amanda Anderson, Rob Christenson, Stephen L. Seliger, Chris Defilippi, Harold I. Feldman, Myles Wolf, John Kusek, Tariq Shafi, Jiang He, Nisha Bansal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Among patients with chronic kidney disease (CKD), the circulating cardiac biomarkers soluble ST2 (SST2), galectin-3, growth differentiation factor-15 (GDF-15), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin-T (hsTnT) possibly reflect pathophysiologic processes and are associated with clinical cardiovascular disease. Whether these biomarkers are associated with electrocardiographic findings is not known. The aim of this study was to test the association between serum cardiac biomarkers and the presence of electrocardiographic changes potentially indicative of subclinical myocardial disease in patients with CKD. Methods: We performed a cross-sectional analysis using 3048 participants from the Chronic Renal Insufficiency Cohort (CRIC) without atrial fibrillation, atrioventricular block, bundle branch block or a pacemaker at the baseline visit. Using logistic regression, we tested the association of each of the five cardiac biomarkers with baseline electrocardiogram (ECG) findings: PR interval >200 ms, QRS interval >100 ms and a prolonged QTc interval. Models were adjusted for demographic variables, measures of kidney function, prevalent cardiovascular disease and cardiovascular risk factors. Results: In adjusted models, hsTnT levels associated with prolonged PR {odds ratio [OR] 1.23 [95% confidence interval (CI) 1.08-1.40]}, QRS [OR 1.28 (95% CI 1.16-1.42)] and QTc [OR 1.94 (95% CI 1.50-2.51)] intervals. NT-proBNP levels were associated with prolonged QRS [OR 1.11 (95% CI 1.06-1.16)] and QTc [OR 1.82 (95% CI 1.58-2.10)] intervals. SST2, galectin-3 and GDF-15 were not significantly associated with any of the ECG parameters. Conclusions: hsTnT and NT-proBNP were associated with ECG measures indicative of subclinical myocardial dysfunction. These results may support future research investigating the significance of myocardial ischemia and volume overload in the pathogenesis of dysfunctional myocardial conduction in CKD.

Original languageEnglish (US)
Pages (from-to)2282-2289
Number of pages8
JournalNephrology Dialysis Transplantation
Volume36
Issue number12
DOIs
StatePublished - Dec 1 2021
Externally publishedYes

Keywords

  • Cardiac biomarkers
  • Cardiovascular disease
  • Chronic kidney disease
  • Myocardial conduction

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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