Cardiovascular-Kidney-Metabolic Syndrome Stages, Echocardiographic Characteristics, and Heart Failure Risk: The...

Area of Science:

• Cardiology
• Gerontology
• Public Health

Background:

• Suboptimal cardiovascular-kidney-metabolic (CKM) health is prevalent in the US, particularly among older adults.
• The predictive value of the CKM syndrome staging framework for incident heart failure (HF) in this demographic is uncertain.

Purpose of the Study:

• To evaluate the association between the CKM syndrome stage and cardiac remodeling.
• To assess the longitudinal risk of incident HF based on CKM stage in older adults.

Main Methods:

• Participants from the ARIC Study (n=5646, ages 66-90) were staged using the AHA CKM framework.
• Echocardiography data assessed cardiac remodeling and function.
• Incident HF risk was analyzed over a median follow-up of 9.0 years.

Main Results:

• Higher CKM stage correlated with adverse left ventricular remodeling and impaired systolic/diastolic function.
• The risk of incident HF significantly increased with higher CKM stages (Stage 2: 2.9 events/1000 person-years; Stage 3: 15.1; Stage 4: 37.4).
• A strong trend (P<0.001) showed increased HF risk with advancing CKM stage.

Conclusions:

• Poor CKM health is widespread in community-dwelling older adults.
• Higher CKM stage is significantly associated with adverse myocardial remodeling.
• The CKM staging framework effectively predicts incident HF risk in this population.