title: Association between Inflammation and Cardiac Geometry in Chronic Kidney Disease: Findings from the CRIC Study.
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH) and myocardial contractile dysfunction are independent predictors of mortality in patients with chronic kidney disease (CKD). The association between inflammatory biomarkers and cardiac geometry has not yet been studied in a large cohort of CKD patients with a wide range of kidney function.
  
  
  METHODS
  Plasma levels of interleukin (IL)-1β, IL-1 receptor antagonist (IL-1RA), IL-6, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β, high-sensitivity C-Reactive protein (hs-CRP), fibrinogen and serum albumin were measured in 3,939 Chronic Renal Insufficiency Cohort study participants. Echocardiography was performed according to the recommendations of the American Society of Echocardiography and interpreted at a centralized core laboratory.
  
  
  RESULTS
  LVH, systolic dysfunction and diastolic dysfunction were present in 52.3%, 11.8% and 76.3% of the study subjects, respectively. In logistic regression analysis adjusted for age, sex, race/ethnicity, diabetic status, current smoking status, systolic blood pressure, urinary albumin- creatinine ratio and estimated glomerular filtration rate, hs-CRP (OR 1.26 [95% CI 1.16, 1.37], p<0.001), IL-1RA (1.23 [1.13, 1.34], p<0.0001), IL-6 (1.25 [1.14, 1.36], p<0.001) and TNF-α (1.14 [1.04, 1.25], p = 0.004) were associated with LVH. The odds for systolic dysfunction were greater for subjects with elevated levels of hs-CRP (1.32 [1.18, 1.48], p<0.001) and IL-6 (1.34 [1.21, 1.49], p<0.001). Only hs-CRP was associated with diastolic dysfunction (1.14 [1.04, 1.26], p = 0.005).
  
  
  CONCLUSIONS
  In patients with CKD, elevated plasma levels of hs-CRP and IL-6 are associated with LVH and systolic dysfunction.
authors.affiliation: Department of Biomedical Sciences, Texas Tech University Health Sciences Center, El Paso, Texas, United States of America.
authors.forename: Jayanta
authors.initials: J
authors.lastname: Gupta
authors.affiliation: The George Washington University School of Medicine, Washington, DC, United States of America.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Dominic
authors.affiliation: Division of Nephrology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Fink
authors.affiliation: Division of Nephrology, University of Michigan, Ann Arbor, Michigan, United States of America.
authors.forename: Akinlolu O
authors.initials: AO
authors.lastname: Ojo
authors.affiliation: The George Washington University School of Medicine, Washington, DC, United States of America.
authors.forename: Ian R
authors.initials: IR
authors.lastname: Barrows
authors.affiliation: Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Muredach P
authors.initials: MP
authors.lastname: Reilly
authors.affiliation: Renal and Electrolyte Division, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Townsend
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Marshall M
authors.initials: MM
authors.lastname: Joffe
authors.affiliation: Joslyn Diabetic Center, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Sylvia E
authors.initials: SE
authors.lastname: Rosas
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Melanie
authors.initials: M
authors.lastname: Wolman
authors.affiliation: Division of Renal Diseases and Hypertension, The George Washington University, Washington, DC, United States of America.
authors.forename: Samir S
authors.initials: SS
authors.lastname: Patel
authors.affiliation: Department of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Keane
authors.affiliation: Renal and Electrolyte Division, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
authors.forename: Harold I
authors.initials: HI
authors.lastname: Feldman
authors.affiliation: Division of Kidney, Urologic, and Hematologic Diseases, The National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States of America.
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
authors.affiliation: Division of Renal Diseases and Hypertension, The George Washington University, Washington, DC, United States of America.
authors.forename: Dominic S
authors.initials: DS
authors.lastname: Raj
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators