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Association of renal biochemical parameters with left ventricular diastolic dysfunction in a community-based elderly
Jingmin Zhou1, Xiaotong Cui1, Xuejuan Jin1
1Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
Insights
Renal function parameters, including serum urea and creatinine, are closely linked to left ventricular diastolic dysfunction (LVDD) in the elderly. This study reveals a significant cardio-renal relationship in this population.
Area of Science:
- Cardiology
- Nephrology
- Geriatrics
Background:
- Left ventricular diastolic dysfunction (LVDD) is a significant cardiovascular condition in the elderly.
- The relationship between LVDD and comprehensive renal parameters beyond traditional hemodynamic indexes remains unclear.
- Understanding this cardio-renal link is crucial for managing cardiovascular health in aging populations.
Purpose of the Study:
- To investigate the association between various renal function parameters and LVDD in community-dwelling elderly individuals.
- To explore novel cardio-renal relationships in geriatric populations.
- To identify specific renal biomarkers predictive of LVDD.
Main Methods:
- A cohort of 1,166 elderly residents (≥ 65 years) from the Shanghai Heart Health Study with complete renal data were analyzed.
- Echocardiography, including tissue Doppler imaging, was employed to assess diastolic function.
- Serum urea, creatinine, urea-to-creatinine ratio, estimated glomerular filtration rate (eGFR), and urinary albumin-to-creatinine ratio (UACR) were measured and correlated with LVDD.
Main Results:
- Prevalence of LVDD increased with elevated serum urea, urea-to-creatinine ratio, and UACR.
- Serum urea, urea-to-creatinine ratio, and UACR showed negative correlations with the E/A ratio and positive correlations with left atrial volume index.
- Urea-to-creatinine ratio and UACR were independently associated with LVDD, alongside serum urea, creatinine, and eGFR for advanced LVDD.
Conclusions:
- Biochemical markers of renal function are significantly associated with left ventricular diastolic dysfunction in the elderly.
- This study elucidates a previously underappreciated cardio-renal relationship in geriatric populations.
- Findings suggest that monitoring renal function may be important for assessing and managing LVDD risk in older adults.
Background:
Relationship of left ventricular diastolic dysfunction (LVDD) with parameters that could provide more information than hemodynamic renal indexes has not been clarified. We aimed to explore the association of comprehensive renal parameters with LVDD in a community-based elderly population.
Methods:
1,166 community residents (aged ≥ 65 years, 694 females) participating in the Shanghai Heart Health Study with complete data of renal parameters were investigated. Echocardiography was used to evaluate diastolic function with conventional and tissue Doppler imaging techniques. Serum urea, creatinine, urea-to-creatinine ratio, estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) were analyzed on their associations with LVDD.
Results:
The prevalence of LVDD increased in proportion to increasing serum urea, urea-to-creatinine ratio and UACR. These three renal parameters were found negatively correlated to peak early (E) to late (A) diastolic velocities ratio (E/A), and positively to left atrial volume index; UACR also positively correlated with E to peak early (E') diastolic mitral annular velocity ratio (E/E'). Serum urea, urea-to-creatinine ratio and UACR correlated with LVDD in logistic univariate regression analysis, and urea-to-creatinine ratio remained independently correlated to LVDD [Odds ratio (OR) 2.82, 95% confidence interval (CI) 1.34-5.95] after adjustment. Serum urea (OR 1.18, 95%CI 1.03-1.34), creatinine (OR 6.53, 95%CI 1.70- -25.02), eGFR (OR 0.22, 95%CI 0.07-0.65) and UACR (OR 2.15, 95%CI 1.42-3.24) were revealed independent correlates of advanced (moderate and severe) LVDD.
Conclusions:
Biochemical parameters of renal function were closely linked with LVDD. This finding described new cardio-renal relationship in the elderly population.
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