Presence of chronic kidney disease and subsequent changes of left ventricular geometry over 4 years in an apparently healthy population aged 60 and older.
Chronic kidney disease (CKD) is associated with increased cardiovascular (CV) risk. Left ventricular geometry (LVG) is a predictor for CV events. However, the influence of CKD on LVG changes in the elderly remains unclear. In this study, we performed echocardiography to evaluate LVG at baseline and at 2 and 4 years after baseline in 120 apparently healthy elderly Chinese who were recruited from a screening of 1,500 individuals. No subjects had a history of organic heart disease or chronic medication. CKD was defined as a glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2, as calculated using the Modification of Diet in Renal Disease (MDRD) study equation. The mean age was 71.5 +/- 3.9 years (range: 60-81 years). The prevalences of CKD, concentric remodeling, eccentric hypertrophy and concentric hypertrophy were significantly increased after 4 years (all p < or = 0.033). The LVG changes were only significant in subjects with CKD at baseline (p = 0.039). If we stratified subjects into those with favorable (normal and concentric remodeling) and those with unfavorable LVG (eccentric hypertrophy and concentric hypertrophy), the presence of CKD was an independent predictor for unfavorable LVG after 4 years both in univariate and multivariate analysis (odds ratio [OR] = 3.18 and 3.70, p = 0.011 and 0.015, respectively). This longitudinal study showed that aging was related to increased prevalence of CKD and changes of LVG. The presence of CKD is associated with changes of LVG toward unfavorable forms. These findings might partially explain why subjects with CKD have a higher CV risk and could provide knowledge essential to the assessment of cardiac structure and disease in older subjects.
Lee
Ya-Ting
YT
Division of Nephrology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
Chiu
Herng-Chia
HC
Su
Ho-Ming
HM
Voon
Wen-Chol
WC
Lin
Tsung-Hsien
TH
Lai
Wen-Ter
WT
Sheu
Sheng-Hsiung
SH
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology* / Q000502:physiology*; D002908:Chronic Disease; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000473:pathology* / Q000503:physiopathology*; D007674:Kidney Diseases / Q000473:pathology* / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis