Mild renal dysfunction is associated with electrocardiographic left ventricular hypertrophy.
BACKGROUND
Both renal dysfunction and left ventricular hypertrophy (LVH) are signs of end-organ damage, risk markers of cardiovascular (CV) disease and chronic heart failure. In selected populations such as those with diabetes or hypertension, renal dysfunction was found to be related to LVH. We studied the relation between renal dysfunction and LVH in a cross-sectional study in 8592 inhabitants from Groningen, The Netherlands.


METHODS
Standard 12-lead electrocardiograms were recorded, and LVH was classified using the Cornell voltage duration product. Renal dysfunction was defined as creatinine clearance <60 mL/min/1.73 m(2) or microalbuminuria (30 to 300 mg/24 h).


RESULTS
Electrocardiographic signs of LVH were present in 396 of subjects (5.3%). Subjects with LVH were older and had a more extensive CV risk profile. We found that LVH was more prevalent in subjects with renal dysfunction than in those without (8% v 4%, P < .001). Multivariate regression analysis demonstrated that renal dysfunction was independently related to a 1.47-fold increased risk of the presence of LVH (95% CI = 1.15 to 1.88, P = .009). In addition, both creatinine clearance (OR = 1.56, 95% CI = 1.07 to 2.2, P = .044) and microalbuminuria (OR = 1.37, 95% CI = 1.04 to 1.80, P = .024) were independently associated with the presence of LVH.


CONCLUSIONS
Subjects with mild renal dysfunction have a substantially higher risk of LVH on electrocardiography than those without renal dysfunction.
Smilde
Tom D J
TD
Department of Cardiology, Thoraxcenter, University Hospital Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB Gronigen, The Netherlands. t.d.j.smilde@thorax.azg.nl
Asselbergs
Folkert W
FW
Hillege
Hans L
HL
Voors
Adriaan A
AA
Kors
Jan A
JA
Gansevoort
Ron T
RT
van Gilst
Wiek H
WH
de Jong
Paul E
PE
Van Veldhuisen
Dirk J
DJ
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000150:complications; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index