Abstract 1488: Reduced Renal Function is Associated with Increased Aortic Stiffness but not with Left Ventricular Systolic or Diastolic Dysfunction in Patients Undergoing Cardiac Catheterization for Coronary Artery Disease
Although reduced renal function is associated with increased risk for cardiovascular events in various populations, including coronary artery disease (CAD) patients, mechanisms underlying the association remain to be fully elucidated. We hypothesized that increased aortic stiffness and left ventricular (LV) dysfunction may contribute to the increased risk associated with reduced renal function in CAD patients. We studied 348 consecutive patients (age, 67 ± 8 years; males, 77%) undergoing cardiac catheterization for evaluation of CAD. We stratified patients according to estimated glomerular filtration rate (eGFR) of 35 and 60 ml/min/1.73m2 and examined the relation of eGFR with augmentation index (AI) of ascending aortic pressure and indices of LV systolic and diastolic function (ejection fraction [EF], time constant of decrease in LV pressure [Tau] and LV end-diastolic pressure [EDP]). eGFR correlated with AI (P for trend <0.001) but not with indices of systolic or diastolic function (all P for trend >0.1; Figure⇓). After adjustment for potential confounders, including age, height, mean aortic pressure, heart rate, traditional cardiovascular risk factors and the severity of CAD, the correlation of eGFR with AI remained significant (AI, adjusted mean ± SE, 0.423 ± 0.013, 0.402 ± 0.008, and 0.385 ± 0.018, for the lower, middle and higher tertiles of eGFR, respectively, P for trend <0.05). In conclusion, decreased eGFR is associated with increased AI but not with indices of systolic or diastolic function in CAD patients. Increased aortic stiffness may be a mechanistic link between reduced renal function and increased risk for cardiovascular events in this population.