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

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

doi:10.3390/jcm12051818

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

J Clin Med. 2023 Feb 24;12(5):1818. doi: 10.3390/jcm12051818.

Authors

Xiaozhao Lu^{1

2}, Qiang Li^{1

2}, Jingru Deng^{1

2}, Yu Kang^{1

2}, Guoxiao Liang^{1

2}, Linxiao Deng³, Lei Guo⁴, Haodong Ruan⁴, Zibi Peng⁴, Jiaxi Li⁴, Ning Tan^{1

2}, Jiyan Chen^{1

2}, Jin Liu^{1

2}, Amanda Y Wang^{5

6

7}, Yong Liu^{1

2}

Affiliations

¹ Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
² Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China.
³ The First Clinical School of Medicine, Guangdong Medical University, Zhanjiang 524000, China.
⁴ The School of Pharmacy, Guangdong Medical University, Dongguan 523000, China.
⁵ The Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia.
⁶ The Renal and Metabolic Division, George Institute for Global Health, The University of New South Wales, Sydney, NSW 2042, Australia.
⁷ Department of Renal Medicine, Concord Clinical School, The University of Sydney, Sydney, NSW 2006, Australia.

Abstract

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 m² 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.

Keywords: echocardiography; left ventricular function; left ventricular hypertrophy; renal function.

Abstract

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