The role of cardiac remodeling associated with renal function in mediating cardiovascular event outcomes

Area of Science:

• Cardiology
• Nephrology
• Biomedical Science

Background:

• Cardiovascular remodeling is a known risk factor for cardiovascular events.
• The role of renal function in cardiovascular remodeling and subsequent risk is not well understood.
• Investigating the interplay between kidney function and heart health is crucial for understanding cardiovascular disease.

Purpose of the Study:

• To investigate the association between reduced renal function and cardiovascular remodeling.
• To evaluate the mediating role of left ventricular remodeling and cardiometabolic diseases in the relationship between renal function and cardiovascular outcomes.
• To explore the impact of declining estimated glomerular filtration rate (eGFR-cysC) on cardiovascular risk.

Main Methods:

• Utilized data from the UK Biobank study.
• Employed multiple mediation analyses and Cox regression models.
• Assessed renal function using cystatin C-based eGFR (eGFR-cysC).
• Analyzed left ventricular remodeling (volume, mass) and systolic function.

Main Results:

• Lower eGFR-cysC was independently associated with increased risks of cardiovascular events and mortality.
• Declining eGFR-cysC showed a progressive relationship with adverse left ventricular remodeling and impaired systolic function.
• Adverse left ventricular remodeling and cardiometabolic diseases were identified as significant independent mediators.

Conclusions:

• Reduced renal function contributes to adverse cardiovascular phenotypes through left ventricular remodeling and cardiometabolic diseases.
• These factors independently mediate the relationship between impaired kidney function and adverse cardiovascular outcomes.
• Understanding these pathways can inform strategies for managing cardiovascular risk in patients with reduced renal function.