Document Detail


Left ventricular hypertrophy as a determinant of renal outcome in patients with high cardiovascular risk.
MedLine Citation:
PMID:  20706134     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The prognostic importance of left ventricular hypertrophy (LVH) on renal impairment has not been addressed previously. We investigated whether LVH determines renal outcomes in patients with high cardiovascular risk.
METHODS: We retrospectively studied 6163 men with high cardiovascular risk (68 ± 13 years, 23% with coronary artery disease, 34% with diabetes, 83% with hypertension and 30% smokers) followed for a period of 14 years. Left ventricular mass index was assessed at baseline, whereas kidney function and blood pressure levels were determined at both baseline and the end of the follow-up period. Renal outcomes were doubling of serum creatinine, estimated glomerular filtration rate (eGFR) below 30 ml/min per 1.73 m and incident hemodialysis.
RESULTS: During the follow-up, 5.8% (n = 356), 7% (n = 429) and 2.7% (n = 165) of men fulfilled the above-mentioned three outcomes, respectively. After adjustment, for each 42 g/m (1 SD) increase in left ventricular mass index, there was a rise in risk of all renal outcomes by 45.7% (95% confidence interval 28.5-58.3) for doubling of serum creatinine, 51.9% (95% confidence interval 39.7-65%) for eGFR below 30 ml/min per 1.73 m and 58.3% (95% confidence interval 39.7-79.3) for hemodialysis (P < 0.001 for all). Severe LVH (160 < left ventricular mass index ≤ 180 g/m) compared with non-LVH predicted a significant increase in: doubling of serum creatinine by 103.8%, eGFR-guided outcome by 109.1% and hemodialysis by 74.1%. In those with LVH and impaired kidney function at baseline (GFR <60 ml/min per 1.73 m) compared with those without such entities, serum creatinine, eGFR and hemodialysis-guided outcomes were increased by four-fold, 15-fold and 16-fold, respectively.
CONCLUSION: Increased left ventricular mass is a predictor of subsequent kidney dysfunction and should be considered in renal risk stratification in a broad spectrum of men with high cardiovascular risk.
Authors:
Costas Tsioufis; Peter Kokkinos; Chris Macmanus; Costas Thomopoulos; Charles Faselis; Michael Doumas; Christodoulos Stefanadis; Vasilios Papademetriou
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  28     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-15     Completed Date:  2011-02-02     Revised Date:  2011-03-16    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  2299-308     Citation Subset:  IM    
Affiliation:
Georgetown Medical Centers, Washington, DC, USA. ktsioufis@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Blood Pressure
Coronary Artery Disease / diagnosis*,  pathology
Creatinine / blood
Female
Glomerular Filtration Rate
Humans
Hypertrophy, Left Ventricular / pathology*
Kidney / pathology*
Male
Middle Aged
Renal Dialysis
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
60-27-5/Creatinine
Comments/Corrections
Comment In:
J Hypertens. 2011 Mar;29(3):621-2; author reply 622   [PMID:  21317728 ]
J Hypertens. 2010 Nov;28(11):2188-9   [PMID:  20706129 ]

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