Abstract 1695: Kidney Dysfunction is Associated With Faster Progression of Left Ventricular Hypertrophy: The Atherosclerosis Risk in Communities (ARIC) Study
BACKGROUND Chronic kidney disease is a well-established and independent risk factor for poor cardiovascular outcomes, and is associated with left ventricular hypertrophy (LVH) in cross-sectional studies. However, the temporal relationship between kidney dysfunction and LVH is unclear.
OBJECTIVE To determine if baseline kidney dysfunction predicts the progression of LVH during 9 years of follow-up.
METHODS Data from the Atherosclerosis Risk in Communities (ARIC) study, a prospective bi-racial cohort study of middle-aged men and women in the United States were used for analysis (n = 15,792). Participants completed 4 visits, approximately 3 years apart (total 9 years of follow-up). Baseline kidney function was defined by glomerular filtration rate (GFR) estimated from serum creatinine at visit 1 using the CKD-EPI equation. Participants were classified as normal function, mild dysfunction, or moderate/severe dysfunction. LVH was defined as a Cornell product > 2440 mm*ms on electrocardiograms obtained at each visit. Cross-sectional and temporal associations between categories of baseline kidney function and LVH were examined using multivariable linear or logistic regression and mixed-effects multi-level models.
RESULTS Overall prevalence of LVH was 5.8% (n = 893) at baseline. In cross-sectional analysis, participants with moderate/severe dysfunction had a higher mean Cornell product and greater odds of LVH compared to those with normal function. Prospectively, all three categories had a significant increase in Cornell product over time. However, those with moderate/severe baseline kidney dysfunction had greater, though not statistically significant, progression of LVH.
CONCLUSION Moderate to severe baseline kidney dysfunction may predict faster progression of LVH during long-term follow up. This finding may have important implications for the care of this high-risk group of patients.