Prognostic values of left ventricular mass index in chronic kidney disease patients

Area of Science:

• Nephrology
• Cardiology
• Clinical Risk Prediction

Background:

• Left ventricular hypertrophy (LVH) is a known risk factor for adverse outcomes, including mortality and heart failure (HF), in patients with chronic kidney disease (CKD).
• The added prognostic value of left ventricular mass index (LVMI) to existing risk models for predicting mortality and incident HF in CKD has not been established.

Purpose of the Study:

• To determine if LVMI provides significant predictive power for mortality and de novo heart failure (HF) beyond established risk scores in patients with chronic kidney disease (CKD).

Main Methods:

• The study analyzed data from 1352 CKD patients in the Chronic Renal Insufficiency Cohort (CRIC) study.
• Left ventricular mass index (LVMI) was assessed using echocardiography.
• Risk prediction for death and HF was evaluated using the Study of Heart and Renal Protection (SHARP) score and a validated CRIC model for HF.

Main Results:

• During a median follow-up of 7.7 years, 326 deaths and 208 incident HF events occurred.
• Both LVMI and the SHARP score, along with the CRIC HF model, were significantly associated with risks of death and HF (P < 0.001).
• LVMI demonstrated inferior discriminatory power for death and HF compared to the SHARP score and CRIC HF model, with minimal improvement (2-4.8%) in risk reclassification when added to these models.

Conclusions:

• In patients with chronic kidney disease (CKD), measuring left ventricular mass index (LVMI) alone does not appear to offer substantial prognostic value for stratifying the risk of death or heart failure (HF).
• Existing risk models, such as the SHARP score and CRIC HF model, are more effective for risk prediction in this population.