title: Urinary albumin excretion, even within the normal range, predicts an increase in left ventricular mass over the following 5 years.
abstract: There is increasing evidence that urinary albumin excretion, even when below the accepted threshold values for normal excretion, may have significant impact on future cardiovascular risks. To further define this, a total of 1086 patients, aged 45 years and older from the population-based, longitudinal 'Study of Health in Pomerania' were evaluated. Patients had echocardiographic analysis at baseline and 5-year follow-up, and were grouped into quartiles according to their baseline urinary albumin-to-creatinine ratio. At baseline, left ventricular mass in the first three quartiles was similar; however, the fourth quartile was significantly elevated and further increased over the 5-year follow-up. In the first quartile, the albumin-to-creatinine ratio and left ventricular mass did not significantly change over 5 years. In the second and third quartiles, the left ventricular mass progressively increased and was significantly correlated with the albumin-to-creatinine ratio. In multivariable analysis, this association was independent of other common cardiovascular risk factors and applicable to both genders. Our study found that the urinary albumin-to-creatinine ratio, even below the current threshold for definition of microalbuminuria, is significantly associated with increased left ventricular mass.
authors.affiliation: Klinik und Poliklinik für Innere Medizin B, Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald, 17487 Greifswald, Germany. ThorstenReffelmann@web.de
authors.forename: Thorsten
authors.initials: T
authors.lastname: Reffelmann
authors.forename: Marcus
authors.initials: M
authors.lastname: Dörr
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Nele
authors.initials: N
authors.lastname: Friedrich
authors.forename: Alexander
authors.initials: A
authors.lastname: Krebs
authors.forename: Till
authors.initials: T
authors.lastname: Ittermann
authors.forename: Stephan B
authors.initials: SB
authors.lastname: Felix
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors