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Objective: This study was designed to investigate whether plasma concentration of cardiotrophin-1(CT-1), a cytokine that induces cardiomyocyte hypertrophy and stimulates cardiac fibroblasts, is related to hypertensive heart disease, as defined by the presence of echocardiographically assessed left ventricular hypertrophy(LVH). Methods: The study was performed in 31 normotensive subjects and 111 patients with never-treated essential hypertension(54 without LVH and 57 with LVH). Causes of LVH other than hypertension were excluded after a complete medical workup. A novel enzyme-linked immunosorbent assay was developed to measure plasma CT-1. Results: Plasma CT-1 was increased(P< 0.001) in hypertensives compared with normotensives. The value of CT-1 was higher(P< 0.001) in hypertensives with LVH than in hypertensives without LVH. Some 31%of patients without LVH exhibited values of CT-1 above the upper normal limit in normotensives. A direct correlation was found between CT-1 and left ventricular mass index(r=0.319, P< 0.001) in all subjects. Receiver operating characteristic curves showed that a cutoff of 39 fmol/ml for CT-1 provided 75%specificity and 70%sensitivity for predicting LVH with a relative risk of 6.21(95%confidence interval, 2.95 to 13.09). Conclusions: These results show an association between LVH and the plasma concentration of CT-1 in essential hypertension. Although preliminary, these findings suggest that the determination of CT-1 may be an easy and reliable method for the initial screening and diagnosis of hypertensive heart disease.