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Associations of Calciprotein Particle Maturation Time with Echocardiographic Measures in the CRIC Study
Ashwin Sunderraj1,2, Xuan Cai3, Andreas Pasch4,5
1Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Insights
T50, a measure of mineral stress, did not show an association with left ventricular abnormalities in chronic kidney disease patients after adjusting for key health factors. This finding suggests T50 may not be a reliable predictor of cardiac changes in this population.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Vascular calcification is prevalent in chronic kidney disease (CKD) and linked to poor cardiac outcomes.
- T50 quantifies mineral stress and is implicated in vascular calcification.
Purpose of the Study:
- To investigate the association between T50 and left ventricular (LV) echocardiographic abnormalities in CKD patients.
- To determine if mineral stress (T50) predicts cardiac structural changes in the Chronic Renal Insufficiency Cohort (CRIC).
Main Methods:
- Cross-sectional analysis using linear and multinomial logistic regression models.
- Examined associations of T50 with LV mass index, concentric remodeling, and concentric/eccentric hypertrophy.
- Adjusted for demographics, clinical factors, cardiovascular disease history, and kidney function (eGFR).
Main Results:
- In unadjusted models, lower T50 was linked to increased LV mass and hypertrophy.
- After multivariable adjustment, these associations were no longer significant for LV mass index, eccentric hypertrophy, or concentric hypertrophy.
- No significant association remained between T50 and LV abnormalities after accounting for confounders.
Conclusions:
- T50 was not significantly associated with left ventricular remodeling or hypertrophy in CKD patients.
- Multivariable adjustment, including kidney function, attenuated any observed associations.
- T50 may not be an independent predictor of echocardiographic abnormalities in this cohort.
Introduction:
Vascular calcification is common in chronic kidney disease (CKD) and is associated with adverse cardiac outcomes. We investigated the relationship of T50, a measure of mineral stress that is associated with vascular calcification, with left ventricular (LV) echocardiographic abnormalities among patients with CKD in the Chronic Renal Insufficiency Cohort (CRIC).
Methods:
Linear regression models were used to examine the cross-sectional associations of T50 with LV mass index, and multinomial logistic regression models were used to analyze the cross-sectional associations of T50 with echocardiographic evidence of LV concentric remodeling, LV concentric hypertrophy, and LV eccentric hypertrophy. Multivariable models are adjusted for age, sex, race/ethnicity, clinical site, systolic blood pressure, body mass index, diabetes, smoking, history of cardiovascular disease, estimated glomerular filtration rate, and 24-h urinary protein.
Results:
Among 2,280 participants, mean age was 59 years and 47.0% were female; 28.5% showed evidence of LV concentric remodeling, 15.0% showed evidence of LV eccentric hypertrophy, and 36.3% showed evidence of LV concentric hypertrophy. In unadjusted model, each 1 standard deviation (1-SD) lower of T50 was associated with greater odds for eccentric hypertrophy and concentric hypertrophy. After sequential adjustment for demographics, clinical factors, and kidney function measures, these associations were lost for eccentric hypertrophy (OR per 1-SD lower: 1.09; 95% CI: 0.92-1.29) and concentric hypertrophy (OR per 1-SD lower: 1.05; 95% CI: 0.91-1.21). In the unadjusted model, each 1-SD lower of T50 was associated with increased LV mass index; this association was lost in the multivariable-adjusted model (β = 0.33; 95% CI: -0.63 to 1.28). Similar findings were observed when T50 was examined in quartiles.
Conclusion:
Among the CRIC cohort, T50 was not associated with LV concentric remodeling, LV eccentric hypertrophy, or LV concentric hypertrophy after multivariable adjustment that included measures of kidney function.
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