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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Verheyen, N; Meinitzer, A; Grübler, MR; Ablasser, K; Kolesnik, E; Fahrleitner-Pammer, A; Belyavskiy, E; Trummer, C; Schwetz, V; Pieske-Kraigher, E; Voelkl, J; Alesutan, I; Catena, C; Sechi, LA; Brussee, H; Lewinski, DV; März, W; Pieske, B; Pilz, S; Tomaschitz, A.
Low-grade inflammation and tryptophan-kynurenine pathway activation are associated with adverse cardiac remodeling in primary hyperparathyroidism: the EPATH trial.
Clin Chem Lab Med. 2017; 55(7):1034-1042 Doi: 10.1515/cclm-2016-1159
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Führende Autor*innen der Med Uni Graz
Verheyen Nicolas Dominik
Co-Autor*innen der Med Uni Graz
Ablasser Klemens
Belyavskiy Evgeny
Brussee Helmut
Fahrleitner-Pammer Astrid
Grübler Martin
Kolesnik Ewald
März Winfried
Meinitzer Andreas
Pieske Burkert Mathias
Pilz Stefan
Theiler-Schwetz Verena
Tomaschitz Andreas
Trummer Christian
von Lewinski Dirk

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Primary hyperparathyroidism (pHPT) is associated with low-grade inflammation, left ventricular hypertrophy and increased cardiovascular mortality, but the association between inflammatory markers and parameters of adverse cardiac remodeling is unknown. We investigated the relationship between C-reactive protein (CRP), the essential amino acid tryptophan and its pro-inflammatory derivatives kynurenine and quinolinic acid (QUIN) with echocardiographic parameters. Cross-sectional baseline data from the "Eplerenone in Primary Hyperparathyroidism" trial were analyzed. Patients with any acute illness were excluded. We assessed associations between CRP, serum levels of tryptophan, kynurenine and QUIN and left ventricular mass index (LVMI), left atrial volume index (LAVI) and E/e'. Among 136 subjects with pHPT (79% females), 100 (73%) had arterial hypertension and the prevalence of left ventricular hypertrophy was 52%. Multivariate linear regression analyses with LVMI, LAVI and E/e' as respective dependent variables, and C-reactive protein and tryptophan, kynurenine and QUIN as respective independent variables were performed. Analyses were adjusted for age, sex, blood pressure, parathyroid hormone, calcium and other cardiovascular risk factors. LVMI was independently associated with CRP (adjusted β-coefficient=0.193, p=0.030) and QUIN (β=0.270, p=0.007), but not kynurenine. LAVI was related with CRP (β=0.315, p<0.001), kynurenine (β=0.256, p=0.005) and QUIN (β=0.213, p=0.044). E/e' was related with kynurenine (β=0.221, p=0.022) and QUIN (β=0.292, p=0.006). Tryptophan was not associated with any of the remodeling parameters. [Correction added after online publication (22 April 2017: The sentence "Among 136 subjects with pHPT (79% females), 100 (73%) had left ventricular hypertrophy." was corrected to "Among 136 subjects with pHPT (79% females), 100 (73%) had arterial hypertension and the prevalence of left ventricular hypertrophy was 52%."] Conclusions: Cardiac remodeling is common in pHPT and is associated with low-grade inflammation and activation of the tryptophan-kynurenine pathway. The potential role of kynurenine and QUIN as cardiovascular risk factors may be further investigated in future studies.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Biomarkers - blood
C-Reactive Protein - metabolism
Cross-Sectional Studies -
Echocardiography -
Female -
Humans -
Hyperparathyroidism, Primary - blood
Hyperparathyroidism, Primary - complications
Hyperparathyroidism, Primary - pathology
Inflammation - complications
Kynurenine - blood
Male -
Quinolinic Acid - blood
Tryptophan - blood
Ventricular Remodeling -

Find related publications in this database (Keywords)
cardiac remodeling
primary hyperparathyroidism
quinolinic acid
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