Abstract 14306: Relationship Between Left Ventricular Hypertrophy, Diastolic Function and Outcomes in African Americans With Hypertensive Chronic Kidney Disease: Results From the African American Study of Kidney Disease (AASK) Cohort Study
Background: African Americans with hypertension are at high risk for adverse outcomes from cardiovascular and renal disease. Patients with stage 3 or greater chronic kidney disease (CKD) are at increased risk for cardiovascular disease, including left ventricular (LV) hypertrophy, diastolic dysfunction and heart failure. Our goal was to study prospectively the relationships of LV mass and diastolic dysfunction with subsequent cardiovascular and renal outcomes in the African American Study of Kidney Disease Cohort Study.
Methods and Results: Of 691 patients enrolled in the cohort, 644 had baseline serum creatinine levels and interpretable baseline echocardiograms. Exposures were LV mass and diastolic parameters. Outcomes were cardiovascular events requiring hospitalization or causing death; a renal composite outcome of doubling of serum creatinine or end-stage renal disease (censoring death); and heart failure. With each 10 g/m2.7 increase in LV mass, there was a strong association with subsequent cardiovascular (HR 1.16; 95% CI 1.06-1.27) and renal outcomes (HR 1.10, 95% CI 1.03-1.18) independent of clinical variables. After adjustment for LV mass, age and systolic function, diastolic parameters related to increased filling pressures (deceleration time and mitral E to early diastolic myocardial velocity ratio) were significantly (p<0.05) associated with subsequent heart failure requiring hospitalization.
Conclusions: This is the first study to show a strong relationship between LV mass, diastolic parameters and adverse outcomes in African Americans with chronic kidney disease. These echocardiographic findings may help identify high risk CKD patients for aggressive therapeutic intervention.
- © 2011 by American Heart Association, Inc.