Renal Insufficiency Increases the Combined Risk of Left Ventricular Hypertrophy and Dysfunction in Patients at High Risk of Cardiovascular Diseases

Background: The identification of asymptomatic structural and functional cardiac abnormalities can help us to recognize early and intervene in patients at pre-heart failure (HF). However, few studies have adequately evaluated the associations of renal function and left ventricular (LV) structure and...

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Main Authors: Xiaozhao Lu, Qiang Li, Jingru Deng, Yu Kang, Guoxiao Liang, Linxiao Deng, Lei Guo, Haodong Ruan, Zibi Peng, Jiaxi Li, Ning Tan, Jiyan Chen, Jin Liu, Amanda Y. Wang, Yong Liu
Format: Article
Language:English
Published: MDPI AG 2023-02-01
Series:Journal of Clinical Medicine
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Online Access:https://www.mdpi.com/2077-0383/12/5/1818
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author Xiaozhao Lu
Qiang Li
Jingru Deng
Yu Kang
Guoxiao Liang
Linxiao Deng
Lei Guo
Haodong Ruan
Zibi Peng
Jiaxi Li
Ning Tan
Jiyan Chen
Jin Liu
Amanda Y. Wang
Yong Liu
author_facet Xiaozhao Lu
Qiang Li
Jingru Deng
Yu Kang
Guoxiao Liang
Linxiao Deng
Lei Guo
Haodong Ruan
Zibi Peng
Jiaxi Li
Ning Tan
Jiyan Chen
Jin Liu
Amanda Y. Wang
Yong Liu
author_sort Xiaozhao Lu
collection DOAJ
description Background: The identification of asymptomatic structural and functional cardiac abnormalities can help us to recognize early and intervene in patients at pre-heart failure (HF). However, few studies have adequately evaluated the associations of renal function and left ventricular (LV) structure and function in patients at high risk of cardiovascular diseases (CVD). Methods: Patients undergoing coronary angiography and/or percutaneous coronary interventions were enrolled from the Cardiorenal ImprovemeNt II (CIN-II) cohort study, and their echocardiography and renal function were assessed at admission. Patients were divided into five groups according to their estimated glomerular filtration rate (eGFR). Our outcomes were LV hypertrophy and LV systolic and diastolic dysfunction. Multivariable logistic regression analyses were conducted to investigate the associations of eGFR with LV hypertrophy and LV systolic and diastolic dysfunction. Results: A total of 5610 patients (mean age: 61.6 ± 10.6 years; 27.3% female) were included in the final analysis. The prevalence of LV hypertrophy assessed by echocardiography was 29.0%, 34.8%, 51.9%, 66.7%, and 74.3% for the eGFR categories >90, 61–90, 31–60, 16–30, and ≤15 mL/min per 1.73 m<sup>2</sup> or for patients needing dialysis, respectively. Multivariate logistic regression analysis showed that subjects with eGFR levels of ≤15 mL/min per 1.73 m2 or needing dialysis (OR: 4.66, 95% CI: 2.96–7.54), as well as those with eGFR levels of 16–30 (OR: 3.87, 95% CI: 2.43–6.24), 31–60 (OR: 2.00, 95% CI: 1.64–2.45), and 61–90 (OR: 1.23, 95% CI: 1.07–1.42), were significantly associated with LV hypertrophy. This reduction in renal function was also significantly associated with LV systolic and diastolic dysfunction (all P for trend <0.001). In addition, a per one unit decrease in eGFR was associated with a 2% heightened combined risk of LV hypertrophy and systolic and diastolic dysfunction. Conclusions: Among patients at high risk of CVD, poor renal function was strongly associated with cardiac structural and functional abnormalities. In addition, the presence or absence of CAD did not change the associations. The results may have implications for the pathophysiology behind cardiorenal syndrome.
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spelling doaj.art-ead671f4c0264ca385b61d9120c76d992023-11-17T07:58:45ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01125181810.3390/jcm12051818Renal Insufficiency Increases the Combined Risk of Left Ventricular Hypertrophy and Dysfunction in Patients at High Risk of Cardiovascular DiseasesXiaozhao Lu0Qiang Li1Jingru Deng2Yu Kang3Guoxiao Liang4Linxiao Deng5Lei Guo6Haodong Ruan7Zibi Peng8Jiaxi Li9Ning Tan10Jiyan Chen11Jin Liu12Amanda Y. Wang13Yong Liu14Department of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, ChinaDepartment of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, ChinaDepartment of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, ChinaDepartment of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, ChinaDepartment of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, ChinaThe First Clinical School of Medicine, Guangdong Medical University, Zhanjiang 524000, ChinaThe School of Pharmacy, Guangdong Medical University, Dongguan 523000, ChinaThe School of Pharmacy, Guangdong Medical University, Dongguan 523000, ChinaThe School of Pharmacy, Guangdong Medical University, Dongguan 523000, ChinaThe School of Pharmacy, Guangdong Medical University, Dongguan 523000, ChinaDepartment of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, ChinaDepartment of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, ChinaDepartment of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, ChinaThe Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, AustraliaDepartment of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, ChinaBackground: The identification of asymptomatic structural and functional cardiac abnormalities can help us to recognize early and intervene in patients at pre-heart failure (HF). However, few studies have adequately evaluated the associations of renal function and left ventricular (LV) structure and function in patients at high risk of cardiovascular diseases (CVD). Methods: Patients undergoing coronary angiography and/or percutaneous coronary interventions were enrolled from the Cardiorenal ImprovemeNt II (CIN-II) cohort study, and their echocardiography and renal function were assessed at admission. Patients were divided into five groups according to their estimated glomerular filtration rate (eGFR). Our outcomes were LV hypertrophy and LV systolic and diastolic dysfunction. Multivariable logistic regression analyses were conducted to investigate the associations of eGFR with LV hypertrophy and LV systolic and diastolic dysfunction. Results: A total of 5610 patients (mean age: 61.6 ± 10.6 years; 27.3% female) were included in the final analysis. The prevalence of LV hypertrophy assessed by echocardiography was 29.0%, 34.8%, 51.9%, 66.7%, and 74.3% for the eGFR categories >90, 61–90, 31–60, 16–30, and ≤15 mL/min per 1.73 m<sup>2</sup> or for patients needing dialysis, respectively. Multivariate logistic regression analysis showed that subjects with eGFR levels of ≤15 mL/min per 1.73 m2 or needing dialysis (OR: 4.66, 95% CI: 2.96–7.54), as well as those with eGFR levels of 16–30 (OR: 3.87, 95% CI: 2.43–6.24), 31–60 (OR: 2.00, 95% CI: 1.64–2.45), and 61–90 (OR: 1.23, 95% CI: 1.07–1.42), were significantly associated with LV hypertrophy. This reduction in renal function was also significantly associated with LV systolic and diastolic dysfunction (all P for trend <0.001). In addition, a per one unit decrease in eGFR was associated with a 2% heightened combined risk of LV hypertrophy and systolic and diastolic dysfunction. Conclusions: Among patients at high risk of CVD, poor renal function was strongly associated with cardiac structural and functional abnormalities. In addition, the presence or absence of CAD did not change the associations. The results may have implications for the pathophysiology behind cardiorenal syndrome.https://www.mdpi.com/2077-0383/12/5/1818renal functionechocardiographyleft ventricular functionleft ventricular hypertrophy
spellingShingle Xiaozhao Lu
Qiang Li
Jingru Deng
Yu Kang
Guoxiao Liang
Linxiao Deng
Lei Guo
Haodong Ruan
Zibi Peng
Jiaxi Li
Ning Tan
Jiyan Chen
Jin Liu
Amanda Y. Wang
Yong Liu
Renal Insufficiency Increases the Combined Risk of Left Ventricular Hypertrophy and Dysfunction in Patients at High Risk of Cardiovascular Diseases
Journal of Clinical Medicine
renal function
echocardiography
left ventricular function
left ventricular hypertrophy
title Renal Insufficiency Increases the Combined Risk of Left Ventricular Hypertrophy and Dysfunction in Patients at High Risk of Cardiovascular Diseases
title_full Renal Insufficiency Increases the Combined Risk of Left Ventricular Hypertrophy and Dysfunction in Patients at High Risk of Cardiovascular Diseases
title_fullStr Renal Insufficiency Increases the Combined Risk of Left Ventricular Hypertrophy and Dysfunction in Patients at High Risk of Cardiovascular Diseases
title_full_unstemmed Renal Insufficiency Increases the Combined Risk of Left Ventricular Hypertrophy and Dysfunction in Patients at High Risk of Cardiovascular Diseases
title_short Renal Insufficiency Increases the Combined Risk of Left Ventricular Hypertrophy and Dysfunction in Patients at High Risk of Cardiovascular Diseases
title_sort renal insufficiency increases the combined risk of left ventricular hypertrophy and dysfunction in patients at high risk of cardiovascular diseases
topic renal function
echocardiography
left ventricular function
left ventricular hypertrophy
url https://www.mdpi.com/2077-0383/12/5/1818
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