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Echocardiographic Findings in Patients with Mild to Moderate Chronic Kidney Disease without Symptomatic Heart Failure : A Population-Based Study

Xhakollari, Liana LU ; Leosdottir, Margret LU ; Magnusson, Martin LU ; Holzmann, Martin J ; Nilsson, Peter M LU and Christensson, Anders LU (2019) In CardioRenal Medicine 9(5). p.284-296
Abstract

BACKGROUND: Renal dysfunction is an established risk factor for cardiovascular disease, but early disease states in both organs are poorly studied.

OBJECTIVE: This cross-sectional population-based study aims to investigate if there is an early association between kidney function and echocardiographic markers of cardiac structure and diastolic function.

METHODS: The study population consisted of 1,504 individuals with no prior history of congestive heart failure or asymptomatic left ventricular ejection fraction ≤40% and an estimated glomerular filtration rate (eGFR) based on cystatin C >15 mL/min/1.73 m2. The participants were categorized according to eGFR ≥90, 75-89, 60-74, 45-59, 30-44, and 15-29 mL/min/1.73 m2. We... (More)

BACKGROUND: Renal dysfunction is an established risk factor for cardiovascular disease, but early disease states in both organs are poorly studied.

OBJECTIVE: This cross-sectional population-based study aims to investigate if there is an early association between kidney function and echocardiographic markers of cardiac structure and diastolic function.

METHODS: The study population consisted of 1,504 individuals with no prior history of congestive heart failure or asymptomatic left ventricular ejection fraction ≤40% and an estimated glomerular filtration rate (eGFR) based on cystatin C >15 mL/min/1.73 m2. The participants were categorized according to eGFR ≥90, 75-89, 60-74, 45-59, 30-44, and 15-29 mL/min/1.73 m2. We evaluated associations between eGFR categories and echocardiographic findings specific to cardiac structure and diastolic function.

RESULTS: Associations between eGFR categories and echocardiographic findings were found for left atrium area/body surface area (p = 0.013) indicating structural changes, and peak early mitral valve velocity (A; p = 0.003), peak late atrial mitral valve velocity/peak systolic myocardial velocity at mitral annulus in the lateral wall (E/Élat; p = 0.002), É mean of lateral and septal wall/Á mean of lateral and septal wall (mean É/Á; p = 0.027) indicating diastolic dysfunction. Associations between E/Élat and mean É/Á and eGFR categories were already present in individuals with eGFR 45-60 mL/min/1.73 m2. In sex-specific analysis these associations were only significant among men.

CONCLUSION: A significant association between mild to moderate impairment of renal function and echocardiographic markers of cardiac structure and diastolic function was observed, supporting the hypothesis that interaction between the kidney and heart exists even in the early stages of renal impairment.

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; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
CardioRenal Medicine
volume
9
issue
5
pages
13 pages
publisher
Karger
external identifiers
  • pmid:31238302
  • scopus:85068594130
ISSN
1664-5502
DOI
10.1159/000499835
language
English
LU publication?
yes
additional info
© 2019 S. Karger AG, Basel.
id
125f5c51-edfd-405b-a423-ba64917536db
date added to LUP
2019-06-28 10:27:50
date last changed
2021-05-11 02:40:48
@article{125f5c51-edfd-405b-a423-ba64917536db,
  abstract     = {<p>BACKGROUND: Renal dysfunction is an established risk factor for cardiovascular disease, but early disease states in both organs are poorly studied.</p><p>OBJECTIVE: This cross-sectional population-based study aims to investigate if there is an early association between kidney function and echocardiographic markers of cardiac structure and diastolic function.</p><p>METHODS: The study population consisted of 1,504 individuals with no prior history of congestive heart failure or asymptomatic left ventricular ejection fraction ≤40% and an estimated glomerular filtration rate (eGFR) based on cystatin C &gt;15 mL/min/1.73 m2. The participants were categorized according to eGFR ≥90, 75-89, 60-74, 45-59, 30-44, and 15-29 mL/min/1.73 m2. We evaluated associations between eGFR categories and echocardiographic findings specific to cardiac structure and diastolic function.</p><p>RESULTS: Associations between eGFR categories and echocardiographic findings were found for left atrium area/body surface area (p = 0.013) indicating structural changes, and peak early mitral valve velocity (A; p = 0.003), peak late atrial mitral valve velocity/peak systolic myocardial velocity at mitral annulus in the lateral wall (E/Élat; p = 0.002), É mean of lateral and septal wall/Á mean of lateral and septal wall (mean É/Á; p = 0.027) indicating diastolic dysfunction. Associations between E/Élat and mean É/Á and eGFR categories were already present in individuals with eGFR 45-60 mL/min/1.73 m2. In sex-specific analysis these associations were only significant among men.</p><p>CONCLUSION: A significant association between mild to moderate impairment of renal function and echocardiographic markers of cardiac structure and diastolic function was observed, supporting the hypothesis that interaction between the kidney and heart exists even in the early stages of renal impairment.</p>},
  author       = {Xhakollari, Liana and Leosdottir, Margret and Magnusson, Martin and Holzmann, Martin J and Nilsson, Peter M and Christensson, Anders},
  issn         = {1664-5502},
  language     = {eng},
  month        = {06},
  number       = {5},
  pages        = {284--296},
  publisher    = {Karger},
  series       = {CardioRenal Medicine},
  title        = {Echocardiographic Findings in Patients with Mild to Moderate Chronic Kidney Disease without Symptomatic Heart Failure : A Population-Based Study},
  url          = {http://dx.doi.org/10.1159/000499835},
  doi          = {10.1159/000499835},
  volume       = {9},
  year         = {2019},
}