| Left atrial volume is associated with inflammation and atherosclerosis in patients with kidney disease. | |
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MedLine Citation:
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PMID: 18307439 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Left atrial volume (LAV) is an independent echocardiographic predictor of cardiovascular events in the general population. We evaluated predictors of LAV in patients with advanced chronic kidney disease (CKD). Hypothesis: Increasing LAV identifies increased cardiovascular risk in patients with CKD. METHODS: Transthoracic echocardiography was performed in CKD patients undergoing cardiovascular evaluation prior to listing for renal transplantation. LAV was measured using the biplane area-length formula and indexed for body surface area. Carotid intima-media thickness was assessed by B-mode ultrasound. Lipoproteins were measured by nuclear magnetic resonance spectroscopy. Values are presented as mean (standard deviation). Relationships with LAV were evaluated using univariate and multivariable regression analyses. RESULTS: There were 99 participants (80% white, 68% male). Their mean age was 55.7 (9.3) years. Significant correlates of LAV were systolic blood pressure (r = 0.24), C-reactive protein (r = 0.29), carotid intima-media thickness (r = 0.29), peak transmitral E-wave (r = 0.38), and severity of mitral regurgitation (r = 0.23, P < 0.05 for all). LAV also was higher among individuals with a history of stroke (45 mL/m2 vs 36.3 mL/m2, P = 0.04) and with >75% stenosis on coronary angiography (38.4 mL/m2 vs 31.8 mL/m2, P = 0.03). In regression models, high sensitivity CRP (hs-CRP), the transmitral E-wave velocity, and a history of stroke independently predicted LAV (P < or = 0.05). CONCLUSION: In individuals with advanced CKD, LAV is associated with inflammation, increased early transmitral filling velocities, and atherosclerosis. These findings may indicate increased cardiovascular risk with increasing LAV in patients with CKD. |
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Authors:
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Anupama K Rao; Arjang Djamali; Claudia E Korcarz; Susan E Aeschlimann; Matthew R Wolff; James H Stein |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Echocardiography (Mount Kisco, N.Y.) Volume: 25 ISSN: 0742-2822 ISO Abbreviation: Echocardiography Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-02-29 Completed Date: 2008-06-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8511187 Medline TA: Echocardiography Country: United States |
Other Details:
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Languages: eng Pagination: 264-9 Citation Subset: IM |
Affiliation:
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Division of Cardiovascular Medicine and Section of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Function, Left* Carotid Arteries / pathology, ultrasonography Carotid Artery Diseases / complications*, physiopathology, ultrasonography Echocardiography* Female Heart Atria / physiopathology, ultrasonography* Humans Inflammation Kidney Failure, Chronic / complications, physiopathology*, ultrasonography Male Middle Aged Risk Factors |
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