Document Detail


Left atrial volume is associated with inflammation and atherosclerosis in patients with kidney disease.
MedLine Citation:
PMID:  18307439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Anupama K Rao; Arjang Djamali; Claudia E Korcarz; Susan E Aeschlimann; Matthew R Wolff; James H Stein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  25     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-06-26     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  264-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
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

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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