The significance of catestatin and relaxin-2 in the diagnosis of myocardial remodeling in patients with essential hypertension and type 2 diabetes mellitus

Abstract

Objective — to evaluate the peculiarities of electrocardiographic (ECG) and echocardiographic (EchoCG) parameters in patients with essential hypertension (EH) in combination with type 2 diabetes mellitus (T2DM) and their relationships with plasma catestatin (CTS) and relaxin­‑2 (RLN­­2) levels.
 Materials and methods. Examinations involved 106 patients with EH, from whom 55 subjects had concomitant T2DM, and 30 practically healthy volunteers. The mean age of the participants was (64.06±8.44) years, and women prevailed in the patients’ group (55.9%). All study participants underwent anthropometric data measurement, laboratory and instrumental investigations. The levels of biomarkers CTS and RLN­­2 were determined with the enzyme‑linked immunosorbent assay. Instrumental investigations included electrocardiography and transthoracic echocardiography.
 Results. CTS levels were reduced in patients with concentric (5.04±1.14 ng/mL) and eccentric left ventricular hypertrophy (LVH) (5.08±0.89 ng/mL) compared with the normal geometry (6.63±0.73 ng/mL, p <0.001). The significant correlation has been established between CTS levels and ECG parameters of LVH (Cornell voltage criterion (r=–0.222; p=0.009) and Sokolow‑Lyon index (r=–0.226; p=0.008)), and EchoCG parameters, including LV end‑diastolic dimension (EDD (r=–0.388; p <0.001), LV end‑systolic dimension (ESD (r=–0.453; p <0.001), LV end‑diastolic volume index (EDVi (r=–0.329; p <0.001), LV end‑systolic volume index ESVi (r=–0.415; p <0.001), LV ejection fraction (EF (r=0.469; p <0.001), septal sickness (SS) (r=–0.593; p <0.001), posterior wall thickness (PWS) (r=–0.647; p <0.001), relative wall thickness (RWS) (r=–0.568; p <0.001), and LV myocardial mass index (LVMi) (r=–0.576; p <0.001). Patients with RLN­­2 ≥ 4.69 pg/mL had higher EchoCG parameters, including LV EDD, LV ESD, LV EDVi, LV ESVi, SV, SS, PWS, RWS, LVMi (p <0.05). In addition, a significant positive relationship between CTS and RLN­­2 levels has been revealed (r=0.191; p=0.026), which was also confirmed in the subgroup of patients with RLN­­2 levels above 4.69 pg/mL (r=0.585; p <0.001).
 Conclusions. The decrease in CTS levels at LVH and established correlations with the ECG signs of LVH and EchoCG parameters allow us to consider CTS as a predictor of the development of LVH, especially in patients with EH combined with T2DM.