| Left ventricular hypertrophy as a determinant of renal outcome in patients with high cardiovascular risk. | |
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MedLine Citation:
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PMID: 20706134 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Costas Tsioufis; Peter Kokkinos; Chris Macmanus; Costas Thomopoulos; Charles Faselis; Michael Doumas; Christodoulos Stefanadis; Vasilios Papademetriou |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of hypertension Volume: 28 ISSN: 1473-5598 ISO Abbreviation: J. Hypertens. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-15 Completed Date: 2011-02-02 Revised Date: 2011-03-16 |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 2299-308 Citation Subset: IM |
Affiliation:
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Georgetown Medical Centers, Washington, DC, USA. ktsioufis@gmail.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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60-27-5/Creatinine |
| Comments/Corrections | |
Comment In:
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J Hypertens. 2011 Mar;29(3):621-2; author reply 622
[PMID:
21317728
]
J Hypertens. 2010 Nov;28(11):2188-9 [PMID: 20706129 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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