Relationship between Plasma Taurine Concentrations and Left Ventricular Dysfunction in Hemodialysis Patients / 대한신장학회잡지

ABSTRACT

In maintenance dialysis patients, death is most often due to cardiac disease. The common causes of death in nondiabetic dialysis patients are congestive heart failure. Relation between taurine and cardiac contractility had been reported in animal studies. Uremic patients have taurine deficiency and this may induce impairment in cardiac contractility. We performed this study to evaluate the relationship between plasma taurine concentration and left ventricular(LV) function by echocardiography in clinically stable 23 hemodialysis(HD) patients. HD patients had significantly lower plasma taurine concentrations(29.1+/-9.4 micromol/L) compared to control(57.6+/-17.5 micromol/L). There were significant correlations between plasma taurine concentrations and fractional shortening(FS)(r=0.422, P<0.05), and taurine and LV end-diastolic diameter(LVEDD)(r=-0.531, P<0.01). By partial correlation analysis of controlling hematocrit, this correlations were maintained between taurine and LVEDD(r=-0.46, P<0.05) and there was a tendency of correlation between taurine and FS(r=0.37, P=0.09). There was a significant correlation between plasma taurine concentrations and normalized protein catabolic rate(NPCR)(r=0.42, P<0.05), insulin-like growth factor 1(IGF-I)(r=0.43, P<0.05) and prealbumin(r=0.54, P<0.05). Group I in whom plasma taurine concentrations were below median value had significantly lower FS(29.7+/-8.2 vs. 38.5+/-8.0%, P<0.05) and higher LVEDD(57.7+/-4.7 vs. 53.1+/-3.0mm, P<0.05) and LV mass index(299.2+/-73.1 vs. 192.4+/-49.7g/m2, P<0.05) than group II in whom plasma taurine concentrations were above median value. On linear multiple regression analysis, plasma taurine concentrations and diastolic blood pressure were independently correlated with FS. In conclusion, taurine deficiency may be one of the factors affecting LV dysfunction in maintenance HD patients.