title: Association between inflammatory markers and left atrial enlargement in patients on hemodialysis.
abstract: BACKGROUND
  In individuals with concurrent chronic kidney disease (CKD) and cardiovascular disease (CVD), the association between left atrial volume (LAV) and serum levels of C-reactive protein (CRP) is shown.
  
  
  OBJECTIVE
  Verify the presence of associations between systemic inflammation and LA dilation in patients on hemodialysis (HD) without clinically evident CVD.
  
  
  METHODS
  This was an observational cross-sectional study of a population on HD (> 3 months), which excluded patients with acute or chronic inflammatory diseases (infections, malignancies, autoimmune diseases) hemodynamic instability, use of anti-inflammatory drugs, hyperparathyroidism, arrhythmias, mitral valve disease and prior cardiovascular (CV) events. CRP and interleukin-6 (IL-6) measurements as well as Doppler echocardiography were obtained. Correlation coefficients were determined to evaluate the associations between variables.
  
  
  RESULTS
  A total of 58 patients were included (28 men, aged 55 ± 15 years), on HD for 24 ± 16 months, 45% were hypertensive, 26% diabetic, with median CRP of 5.1 mg/dL and IL-6 of 6.1 pg/dL. CRP significantly correlated with LAV (p = 0.040), LAV index (LAVi, p = 0.02) and mitral inflow E wave (p = 0.014). IL-6, despite the strong association with CRP levels (r = 0.75, p < 0.001), did not correlate with echocardiographic indices. Individuals in the top quartile of CRP had significantly higher LAVi than the others (42 ± 17 versus 32 ± 11 mL/m², p = 0.015).
  
  
  CONCLUSIONS
  In subjects on HD with no prior CV event, there was an association between elevated CRP levels and LA enlargement. The findings suggest an association between physiopathological processes related to left atrial dilation and systemic inflammatory state of patients on HD.
authors.affiliation: Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil. silviohb@cardiol.br
authors.forename: Silvio Henrique
authors.initials: SH
authors.lastname: Barberato
authors.forename: Sérgio Gardano Elias
authors.initials: SG
authors.lastname: Bucharles
authors.forename: Admar Moraes
authors.initials: AM
authors.lastname: de Souza
authors.forename: Costantino Ortiz
authors.initials: CO
authors.lastname: Costantini
authors.forename: Costantino Roberto Frack
authors.initials: CR
authors.lastname: Costantini
authors.forename: Roberto
authors.initials: R
authors.lastname: Pecoits-Filho
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D006332:Cardiomegaly / Q000097:blood* / Q000000981:diagnostic imaging; D015150:Echocardiography, Doppler; D004812:Epidemiologic Methods; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000032:analysis; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D006435:Renal Dialysis
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein