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- Title
Left Atrial Volume Is Associated with Inflammation and Atherosclerosis in Patients with Kidney Disease.
- Authors
Rao, Anupama K.; Djamali, Arjang; Korcarz, Claudia E.; Aeschlimann, Susan E.; Wolff, Matthew R.; Stein, James H.
- Abstract
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 ≤ 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.
- Subjects
KIDNEY diseases; DIAGNOSTIC ultrasonic imaging; DIAGNOSTIC imaging; ULTRASONIC imaging; MULTIVARIATE analysis; MEDICAL radiography
- Publication
Echocardiography, 2008, Vol 25, Issue 3, p264
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/j.1540-8175.2007.00589.x