Study On The Correlation Between Serum Cystatin C And Left Ventricular Hypertrophy In Hypertensive Patients

Objective:Serum cystatin C is an endogenous cysteine protease inhibitor,involved in intracellular and extracellular proteolytic adjustment and myocardial extracellular matrix formation and degradation.Most previous studies have focused on the association between serum cystatin C and cardiovascular and renal vascular diseases such as coronary heart disease.heart failure,hypertension,diabetes,stroke,and chronic kidney disease.However,the clinical association of serum cystatin C in patients with left ventricular hypertrophy is rare.In this study,blood pressure level,laboratory data,including blood sugar,blood fat,liver and kidney function,homocysteine and cysC,were analyzed in patients with hypertension,and the relevant parameters of echocardiography were measured,to explore the relevant factors affecting left ventricular hypertrophy in patients with essential hypertension and the relationship between serum cystatin C and cardiac structural changes in patients with hypertension,so as to provide a valuable basis for the prediction and evaluation of clinical hypertensive left ventricular hypertrophy.Methods:The selected patients were 145 patients with essential hypertension(68 males and 77 females)who visited the department of cardiology of the second affiliated hospital of kunming medical university from May 2019 to December 2019.Including basic information(gender,age,height,weight,smoking and alcohol history,history of basic diseases.history of medication,blood pressure and heart rate,etc.),Laboratory data(biochemical such as blood sugar,blood fat,liver and kidney function,serum homocysteine and cystatin-C,etc.).24h ambulatory blood pressure parameters(24 hSBP,24 hDBP,dSBP.nSBP,dDBP,nDBP,24 hPP,daytime and nighttime blood pressure load,nocturnal systolic blood pressure and diastolic blood pressure drop rate,etc.)and echocardiography parameters(LVDd,LPWT,IVST,LAD,LVEF,etc.)were collected for all the selected patients,We calculated the left ventricular mass index(LVMI),LVMI was divided into LVH group(n=32)and non-LVH group(n=113)To analyze the correlation between cysC and LVH in hypertensive patients.Results:1.There were statistically significant differences in age(Z=-2.39,P=0.017),disease duration(Z=-2.446,P=0.014),and cysC level(Z=-2.350,P=0.019)between patients with LVH in essential hypertension and those without LVH in essential hypertension.The age of LVH group(63[48,68]years)was larger than that of non-LVH group(52[42,61]years),the disease duration of LVH group(7[1.10,12.30]years)was longer than that of non-lvh group(1[0.08,6.00]years),and the cystatin C level of LVH group(0.91[0.79,1.02]mg/L)was higher than that of non-Ivh group(0.80[0.72,0.90]mg/L).2.Pearson correlation analysis was used to find that the duration of disease(r=0.306,P=0.002),24-hour systolic pressure load(r-0.205,P=0.045),24-hour dynamic pulse pressure(r=0.165,P=0.047),cystatin C(r=0.354,P=0.000),and end-stage left atrial diameter(r=0.242,P=0.001)were positively correlated with the left ventricular mass index.3.Pearson correlation analysis was used to find that Serum cystatin C level with end systolic left atrial diameter(r=0.265,P<0.01),Inter-ventricular septal thickness(r=0.333,P<0.01),left ventricular posterior wall thickness(r=0.296,P<0.01),left ventricular weight index(r=0.335,P<0.01)were positively correlated.4.After adjusting for relevant risk factors,multiple linear regression analysis showed that serum cystatin C was positively correlated with Left atrial diameter(?=0.204,P=0.017)?left ventricular posterior wall thickness(?=0.168,P<0.043)and left ventricular mass index(?=0.235,P<0.03).5.After adjusting for related risk factors,the serum cystatin C(OR=9.60;95%CI:1.38-67)and left atrial diameter(OR=1.26;95%CI:1.10-1.43)is an important factor affecting LVH in essential hypertensionConclusions:1.patients with essential hypertension combined with left ventricular hypertrophy had higher cystatin C levels,were older,and had a longer duration of disease.2.Duration of hypertension,24h systolic pressure load,24-hour dynamic pulse pressure,cystatin C,left atrial diameter at the end of systolic period were correlated with left ventricular mass index.3.Serum cystatin C level was closely correlated with cardiac structure,which may be an independent marker of essential hypertensive LVH4.Elevated serum cystatin C levels and left atrial enlargement may be important factors for left ventricular hypertrophy in essential hypertension.