title: Abnormally low and high ankle-brachial indices are independently associated with increased left ventricular mass index in chronic kidney disease.
abstract: Abnormally low and high ankle-brachial indices (ABIs) are associated with high cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD), but the mechanisms responsible for the association are not fully known. This study is designed to assess whether there is a significant correlation between abnormal ABI and echocariographic parameters in patients with CKD stages 3-5. A total of 684 pre-dialysis CKD patients were included in the study. The ABI was measured using an ABI-form device. Patients were classified into ABI <0.9, ≥ 0.9 to <1.3, and ≥ 1.3. Clinical and echocariographic parameters were compared and analyzed. Compared with patients with ABI of ≥ 0.9 to <1.3, the values of left ventricular mass index (LVMI) were higher in patients with ABI <0.9 and ABI ≥ 1.3 (P ≤ 0.004). After the multivariate analysis, patients with ABI <0.9 (β = 0.099, P = 0.004) and ABI ≥ 1.3 (β = 0.143, P<0.001) were independently associated with increased LVMI. Besides, increased LVMI (odds ratio, 1.017; 95% confidence interval, 1.002 to 1.033; P = 0.031) was also significantly associated with ABI <0.9 or ABI ≥1.3. Our study in patients of CKD stages 3-5 demonstrated abnormally low and high ABIs were positively associated with LVMI. Future studies are required to determine whether increased LVMI is a causal intermediary between abnormal ABI and adverse cardiovascular outcomes in CKD.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.forename: Po-Chao
authors.initials: PC
authors.lastname: Hsu
authors.forename: Chun-Yuan
authors.initials: CY
authors.lastname: Chu
authors.forename: Wen-Hsien
authors.initials: WH
authors.lastname: Lee
authors.forename: Szu-Chia
authors.initials: SC
authors.lastname: Chen
authors.forename: Chee-Siong
authors.initials: CS
authors.lastname: Lee
authors.forename: Wen-Chol
authors.initials: WC
authors.lastname: Voon
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods; D005260:Female; D005919:Glomerular Filtration Rate; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology*; D012307:Risk Factors; D013624:Taiwan; D016896:Treatment Outcome