Tohoku J. Exp. Med., 2011, 223(4)

Association between High-Sensitivity C-Reactive Protein and Left Ventricular Diastolic Function Assessed by Echocardiography in Patients with Cardiovascular Risk Factors

HISASHI MASUGATA,¹ SHOICHI SENDA,¹ MICHIO INUKAI,¹ KOJI MURAO,² SATOSHI TADA,³ NAOHISA HOSOMI,⁴ YASUYOSHI IWADO,⁵ TAKAHISA NOMA,⁵ MASAKAZU KOHNO,⁵ TAKASHI HIMOTO¹ and FUMINORI GODA¹

¹Department of Integrated Medicine, Kagawa University, Kagawa, Japan
²Division of Endocrinology and Metabolism, Department of Internal medicine, Kagawa University, Kagawa, Japan
³Department of Laboratory Medicine, Kagawa University, Kagawa, Japan
⁴Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
⁵Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan

High-sensitivity C-reactive protein (hsCRP) has been demonstrated to play a causal role in atherosclerosis and to predict cardiovascular events in the general population. On the other hand, left ventricular (LV) hypertrophy and diastolic dysfunction assessed by echocardiography can also predict cardiovascular events in patients with cardiovascular risk factors. However, there are few data regarding the relationships among hsCRP, LV hypertrophy, and diastolic function. We examined the relationships among hsCRP, LV hypertrophy, and diastolic function in 185 patients (65 ± 11 years), who had no overt heart disease, but had cardiovascular risk factors, including hypertension, diabetes, and dyslipidemia. Echocardiography was performed to measure the left ventricular mass index (LVMI) as a parameter of LV hypertrophy. LV diastolic function was assessed by the ratio (E/A) of early (E) and late (A) diastolic transmitral flows, early diastolic mitral annular velocity (E'), and the ratio (E/E') of E to E' using Doppler echocardiography. The hsCRP was correlated with LVMI (r = 0.228, p = 0.002), E' (r = −0.276, p < 0.001), and E/E' (r = 0.419, p < 0.001). The E/E' as a parameter of LV diastolic function showed the closest correlation to hsCRP. These results indicate that elevated hsCRP reflects LV diastolic dysfunction rather than LV hypertrophy. We therefore suggest that hsCRP may be a marker of subclinical LV diastolic dysfunction in patients with cardiovascular risk factors.

keywords —— high-sensitive CRP; echocardiography; left ventricular diastolic dysfunction; left ventricular hypertrophy; cardiovascular risk factor

© 2011 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2011, 223, 263-268

Correspondence: Hisashi Masugata, M.D., Ph.D., Department of Integrated Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.

e-mail: masugata@med.kagawa-u.ac.jp