Left Ventricular Hypertrophy in Mild and Moderate Reduction in Kidney Function Determined Using Cardiac Magnetic Resonance Imaging and Cystatin C

The Multi-Ethnic Study of Atherosclerosis (MESA)

Andrew Moran, Ronit Katz, Nancy Swords Jenny, Brad Astor, David A. Bluemke, Joao Lima, David Siscovick, Alain G. Bertoni, Michael G. Shlipak

Research output: Contribution to journalArticle

Abstract

Background: Left ventricular (LV) hypertrophy (LVH) is associated with chronic kidney disease, but the association of LVH with a mild decrease in kidney function is not known. We hypothesized that mild and moderate decreases in kidney function, reflected in greater serum cystatin C concentrations, would be linearly associated with a greater prevalence of LVH. Study Design: Cross-sectional observational study. Settings & Participants: Participants in baseline examinations in the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study with several sites in the United States. Predictors: Cystatin C-based estimated glomerular filtration rate (eGFRcysC) and creatinine-based eGFR. Outcomes: LVH and LV mass index. Measurements: Serum cystatin C and creatinine, LV mass obtained by using magnetic resonance imaging. LVH cutoff values for men and women were defined by the upper 95th percentile of LV mass index of all MESA participants without hypertension. Results: Of the 4,971 participants analyzed, mean creatinine-based eGFR was 81 ± 17 (SD) mL/min/1.73 m2 and mean eGFRcysC was 94 ± 32 mL/min/1.73 m2. LVH was distinctly more prevalent (>12%) in only the lowest 2 deciles of eGFRcysC (2). When 435 participants (9%) with stage 3 or higher chronic kidney disease (creatinine-based eGFR <60 mL/min/1.73 m2) were excluded, the odds for LVH increased for each lower category of eGFRcysC less than 75 mL/min/1.73 m2: odds ratio 1.6 for LVH with eGFRcysC of 60 to 75 mL/min/1.73 m2 (95% confidence interval, 1.20 to 2.07; P = 0.001), and odds ratio 2.0 for eGFRcysC less than 60 mL/min/1.73 m2 (95% confidence interval, 1.03 to 3.75; P = 0.04) after adjustment for demographic factors, study site, diabetes, and smoking. The association of lower eGFRcysC with LVH was attenuated after further adjustment for hypertension. Limitations: Cross-sectional rather than longitudinal design, lack of participants with more advanced kidney disease, lack of a direct measurement of glomerular filtration rate. Conclusions: In participants without chronic kidney disease, eGFRcysC of 75 mL/min/1.73 m2 or less was associated with a greater odds of LVH.

Original languageEnglish (US)
Pages (from-to)839-848
Number of pages10
JournalAmerican Journal of Kidney Diseases
Volume52
Issue number5
DOIs
StatePublished - Nov 2008

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Cystatin C
Left Ventricular Hypertrophy
Hypertrophy
Atherosclerosis
Magnetic Resonance Imaging
Kidney
Creatinine
Chronic Renal Insufficiency
Glomerular Filtration Rate
Odds Ratio
Confidence Intervals
Hypertension
Kidney Diseases
Serum
Observational Studies
Cross-Sectional Studies
Smoking
Demography

Keywords

  • cystatin C
  • glomerular filtration rate
  • Kidney disease
  • left ventricular hypertrophy
  • left ventricular mass
  • magnetic resonance imaging (MRI)

ASJC Scopus subject areas

  • Nephrology

Cite this

Left Ventricular Hypertrophy in Mild and Moderate Reduction in Kidney Function Determined Using Cardiac Magnetic Resonance Imaging and Cystatin C : The Multi-Ethnic Study of Atherosclerosis (MESA). / Moran, Andrew; Katz, Ronit; Jenny, Nancy Swords; Astor, Brad; Bluemke, David A.; Lima, Joao; Siscovick, David; Bertoni, Alain G.; Shlipak, Michael G.

In: American Journal of Kidney Diseases, Vol. 52, No. 5, 11.2008, p. 839-848.

Research output: Contribution to journalArticle

Moran, Andrew ; Katz, Ronit ; Jenny, Nancy Swords ; Astor, Brad ; Bluemke, David A. ; Lima, Joao ; Siscovick, David ; Bertoni, Alain G. ; Shlipak, Michael G. / Left Ventricular Hypertrophy in Mild and Moderate Reduction in Kidney Function Determined Using Cardiac Magnetic Resonance Imaging and Cystatin C : The Multi-Ethnic Study of Atherosclerosis (MESA). In: American Journal of Kidney Diseases. 2008 ; Vol. 52, No. 5. pp. 839-848.
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abstract = "Background: Left ventricular (LV) hypertrophy (LVH) is associated with chronic kidney disease, but the association of LVH with a mild decrease in kidney function is not known. We hypothesized that mild and moderate decreases in kidney function, reflected in greater serum cystatin C concentrations, would be linearly associated with a greater prevalence of LVH. Study Design: Cross-sectional observational study. Settings & Participants: Participants in baseline examinations in the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study with several sites in the United States. Predictors: Cystatin C-based estimated glomerular filtration rate (eGFRcysC) and creatinine-based eGFR. Outcomes: LVH and LV mass index. Measurements: Serum cystatin C and creatinine, LV mass obtained by using magnetic resonance imaging. LVH cutoff values for men and women were defined by the upper 95th percentile of LV mass index of all MESA participants without hypertension. Results: Of the 4,971 participants analyzed, mean creatinine-based eGFR was 81 ± 17 (SD) mL/min/1.73 m2 and mean eGFRcysC was 94 ± 32 mL/min/1.73 m2. LVH was distinctly more prevalent (>12{\%}) in only the lowest 2 deciles of eGFRcysC (2). When 435 participants (9{\%}) with stage 3 or higher chronic kidney disease (creatinine-based eGFR <60 mL/min/1.73 m2) were excluded, the odds for LVH increased for each lower category of eGFRcysC less than 75 mL/min/1.73 m2: odds ratio 1.6 for LVH with eGFRcysC of 60 to 75 mL/min/1.73 m2 (95{\%} confidence interval, 1.20 to 2.07; P = 0.001), and odds ratio 2.0 for eGFRcysC less than 60 mL/min/1.73 m2 (95{\%} confidence interval, 1.03 to 3.75; P = 0.04) after adjustment for demographic factors, study site, diabetes, and smoking. The association of lower eGFRcysC with LVH was attenuated after further adjustment for hypertension. Limitations: Cross-sectional rather than longitudinal design, lack of participants with more advanced kidney disease, lack of a direct measurement of glomerular filtration rate. Conclusions: In participants without chronic kidney disease, eGFRcysC of 75 mL/min/1.73 m2 or less was associated with a greater odds of LVH.",
keywords = "cystatin C, glomerular filtration rate, Kidney disease, left ventricular hypertrophy, left ventricular mass, magnetic resonance imaging (MRI)",
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T1 - Left Ventricular Hypertrophy in Mild and Moderate Reduction in Kidney Function Determined Using Cardiac Magnetic Resonance Imaging and Cystatin C

T2 - The Multi-Ethnic Study of Atherosclerosis (MESA)

AU - Moran, Andrew

AU - Katz, Ronit

AU - Jenny, Nancy Swords

AU - Astor, Brad

AU - Bluemke, David A.

AU - Lima, Joao

AU - Siscovick, David

AU - Bertoni, Alain G.

AU - Shlipak, Michael G.

PY - 2008/11

Y1 - 2008/11

N2 - Background: Left ventricular (LV) hypertrophy (LVH) is associated with chronic kidney disease, but the association of LVH with a mild decrease in kidney function is not known. We hypothesized that mild and moderate decreases in kidney function, reflected in greater serum cystatin C concentrations, would be linearly associated with a greater prevalence of LVH. Study Design: Cross-sectional observational study. Settings & Participants: Participants in baseline examinations in the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study with several sites in the United States. Predictors: Cystatin C-based estimated glomerular filtration rate (eGFRcysC) and creatinine-based eGFR. Outcomes: LVH and LV mass index. Measurements: Serum cystatin C and creatinine, LV mass obtained by using magnetic resonance imaging. LVH cutoff values for men and women were defined by the upper 95th percentile of LV mass index of all MESA participants without hypertension. Results: Of the 4,971 participants analyzed, mean creatinine-based eGFR was 81 ± 17 (SD) mL/min/1.73 m2 and mean eGFRcysC was 94 ± 32 mL/min/1.73 m2. LVH was distinctly more prevalent (>12%) in only the lowest 2 deciles of eGFRcysC (2). When 435 participants (9%) with stage 3 or higher chronic kidney disease (creatinine-based eGFR <60 mL/min/1.73 m2) were excluded, the odds for LVH increased for each lower category of eGFRcysC less than 75 mL/min/1.73 m2: odds ratio 1.6 for LVH with eGFRcysC of 60 to 75 mL/min/1.73 m2 (95% confidence interval, 1.20 to 2.07; P = 0.001), and odds ratio 2.0 for eGFRcysC less than 60 mL/min/1.73 m2 (95% confidence interval, 1.03 to 3.75; P = 0.04) after adjustment for demographic factors, study site, diabetes, and smoking. The association of lower eGFRcysC with LVH was attenuated after further adjustment for hypertension. Limitations: Cross-sectional rather than longitudinal design, lack of participants with more advanced kidney disease, lack of a direct measurement of glomerular filtration rate. Conclusions: In participants without chronic kidney disease, eGFRcysC of 75 mL/min/1.73 m2 or less was associated with a greater odds of LVH.

AB - Background: Left ventricular (LV) hypertrophy (LVH) is associated with chronic kidney disease, but the association of LVH with a mild decrease in kidney function is not known. We hypothesized that mild and moderate decreases in kidney function, reflected in greater serum cystatin C concentrations, would be linearly associated with a greater prevalence of LVH. Study Design: Cross-sectional observational study. Settings & Participants: Participants in baseline examinations in the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study with several sites in the United States. Predictors: Cystatin C-based estimated glomerular filtration rate (eGFRcysC) and creatinine-based eGFR. Outcomes: LVH and LV mass index. Measurements: Serum cystatin C and creatinine, LV mass obtained by using magnetic resonance imaging. LVH cutoff values for men and women were defined by the upper 95th percentile of LV mass index of all MESA participants without hypertension. Results: Of the 4,971 participants analyzed, mean creatinine-based eGFR was 81 ± 17 (SD) mL/min/1.73 m2 and mean eGFRcysC was 94 ± 32 mL/min/1.73 m2. LVH was distinctly more prevalent (>12%) in only the lowest 2 deciles of eGFRcysC (2). When 435 participants (9%) with stage 3 or higher chronic kidney disease (creatinine-based eGFR <60 mL/min/1.73 m2) were excluded, the odds for LVH increased for each lower category of eGFRcysC less than 75 mL/min/1.73 m2: odds ratio 1.6 for LVH with eGFRcysC of 60 to 75 mL/min/1.73 m2 (95% confidence interval, 1.20 to 2.07; P = 0.001), and odds ratio 2.0 for eGFRcysC less than 60 mL/min/1.73 m2 (95% confidence interval, 1.03 to 3.75; P = 0.04) after adjustment for demographic factors, study site, diabetes, and smoking. The association of lower eGFRcysC with LVH was attenuated after further adjustment for hypertension. Limitations: Cross-sectional rather than longitudinal design, lack of participants with more advanced kidney disease, lack of a direct measurement of glomerular filtration rate. Conclusions: In participants without chronic kidney disease, eGFRcysC of 75 mL/min/1.73 m2 or less was associated with a greater odds of LVH.

KW - cystatin C

KW - glomerular filtration rate

KW - Kidney disease

KW - left ventricular hypertrophy

KW - left ventricular mass

KW - magnetic resonance imaging (MRI)

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