TY - JOUR
T1 - Left ventricular hypertrophy as a determinant of renal outcome in patients with high cardiovascular risk
AU - Tsioufis, Costas
AU - Kokkinos, Peter
AU - MacManus, Chris
AU - Thomopoulos, Costas
AU - Faselis, Charles
AU - Doumas, Michael
AU - Stefanadis, Christodoulos
AU - Papademetriou, Vasilios
PY - 2010/11
Y1 - 2010/11
N2 - 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.
AB - 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.
KW - cardiovascular risk
KW - left ventricular hypertrophy
KW - renal outcome
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U2 - 10.1097/HJH.0b013e32833d95fe
DO - 10.1097/HJH.0b013e32833d95fe
M3 - Article
C2 - 20706134
AN - SCOPUS:77958458657
SN - 0263-6352
VL - 28
SP - 2299
EP - 2308
JO - Journal of Hypertension
JF - Journal of Hypertension
IS - 11
ER -