scholarly journals Abnormalities in Cardiac Structure and Function among Individuals with CKD: The COMBINE Trial

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0005022021
Author(s):  
Ann A. Wang ◽  
Xuan Cai ◽  
Anand Srivastava ◽  
Pottumarthi V. Prasad ◽  
Stuart M. Sprague ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Healthy Volunteers ◽  
Fibroblast Growth Factor 23 ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Cross Sectional ◽  
Urine Albumin ◽  
Unit Increase ◽  
Cardiac Structure And Function ◽  
And Function

Background: Individuals with chronic kidney disease (CKD) have a high burden of cardiovascular disease (CVD). Abnormalities in cardiac structure and function represent subclinical CVD and can be assessed by cardiac magnetic resonance imaging (cMRI). Methods: We investigated differences in cMRI parameters in 140 individuals with CKD stages 3b-4 who participated in the CKD Optimal Management with BInders and NicotinamidE (COMBINE) trial and in 24 age-and sex matched healthy volunteers. Among COMBINE participants, we examined the associations of estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), phosphate, fibroblast growth factor 23 (FGF23), and parathyroid hormone (PTH) with baseline (N=140) and 12-month change (N=112) in cMRI parameters. Results: Mean (standard deviation [SD]) age of the COMBINE participants and healthy volunteers were 64.9 (11.9) and 60.4 (7.3) years. The mean (SD) baseline eGFR in COMBINE participants was 32.1 (8.0) and 85.9 (16.0) ml/ min/1.73m2 in healthy volunteers. The median (interquartile range [IQR]) UACR in COMBINE participants was 154 (20.3 - 540.0) mg/g. Individuals with CKD had lower mitral valve E/A ratio compared to healthy volunteers (β estimate -0.13 CKD vs. non-CKD, 95% confidence interval [CI] -0.24, -0.012). Among COMBINE participants, multivariable linear regression analyses showed that higher UACR was significantly associated with lower mitral valve E/A ratio (β-estimate per 1 unit increase in natural log UACR -0.06, 95% CI -0.09, -0.03). This finding was preserved among individuals without baseline CVD. UACR was not associated with 12-month change in any cMRI parameter. eGFR, phosphate, FGF23, and PTH were not associated with any cMRI parameter in cross-sectional or change analyses. Conclusions: Individuals with CKD stages 3b-4 have evidence of cMRI abnormalities. Albuminuria was independently associated with diastolic dysfunction assessed by mitral valve E/A ratio in individuals with CKD with and without clinical CVD, but was not associated with change in any cMRI parameter.

Abstract P015: Fibroblast Growth Factor 23 and Echocardiographic Measures of Cardiac Structure and Function among African Americans: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Jeffrey R Misialek ◽  
Alvaro Alonso ◽  
Erin D Michos ◽  
Scott D Solomon ◽  
Amil M Shah ◽  
...  
Keyword(s):  
Growth Factor ◽  
Fibroblast Growth Factor ◽  
Fibroblast Growth Factor 23 ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Fibroblast Growth ◽  
Lv Mass ◽  
Cardiac Structure And Function ◽  
And Function ◽  
Aric Study

Introduction: Fibroblast growth factor 23 (FGF23), an endocrine hormone, induced left ventricular (LV) hypertrophy through direct action in experimental animal models. The association of FGF23 with echocardiographic measures in humans is relatively uncharacterized. Hypothesis: Higher levels of FGF23 will be cross-sectionally associated with more adverse echocardiographic measures of LV structure and function. Methods: We conducted a cross-sectional analysis of 2086 African-American adults (66% female, median age 55) from a subset of the ARIC Study, a community-based cohort in the United States. Intact active FGF23 was assessed in blood samples collected at ARIC visit two (1990-1992). Echocardiography was performed at visit three (1993-1995) in participants recruited at the Jackson field center only. We used multivariable linear regression to evaluate the associations of FGF23 (per 15 pg/mL change) with echocardiographic measures after adjustment for traditional cardiovascular risk factors assessed at visit two. We also examined differences in observed associations by age and sex using interaction terms. Results: FGF23 was significantly associated with greater left atrial diameter and LV mass index (Table). A significant sex interaction was identified for LV diameter (p-interaction = 0.005). No association was observed in men while a positive association was observed among women. An adverse, decreasing trend in percent fractional shortening of the LV diameter at higher levels of FGF was stronger in individuals aged >55 (p-interaction = 0.03). No linear association was found between FGF23 and E/A ratio. Conclusion: FGF23 was associated with higher LV mass, larger LV size, and lower LV systolic function. These findings are consistent with results from experimental animal studies and provide evidence suggesting that cardiac structure and function may be influenced by FGF23 in humans. Prospective studies are needed to evaluate whether FGF23 is associated with change in markers of cardiac structure and function.

Cardiac structure and function in monozygotic twin pairs discordant for physical fitness

2005 ◽  
Vol 99 (2) ◽  
pp. 535-541 ◽  
Author(s):  
Jarna C. Hannukainen ◽  
Urho M. Kujala ◽  
Jyri Toikka ◽  
Olli J. Heinonen ◽  
Jukka Kapanen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Monozygotic Twins ◽  
Monozygotic Twin ◽  
Left Ventricular ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Cross Sectional ◽  
Echocardiographic Parameters ◽  
Cardiac Structure And Function ◽  
And Function

Cross-sectional studies in athletes and untrained subjects suggest that exercise training induces adaptations in cardiac structure and function. However, the role of genetic variation on the results has largely been ignored in these studies. The purpose of this study was to investigate the effects of long-term volitionally increased physical activity on electrocardiographic and echocardiographic parameters in male monozygotic twin pairs discordant for physical activity and fitness. On the basis of the mailed questionnaires, a telephone interview, and the inclusion criteria, 12 pairs of young adult male monozygotic twins were recruited from a Finnish twin cohort. All subjects completed a maximal oxygen uptake (V̇o2 max) test and electrocardiography and echocardiography studies. Nine pairs had at least 9% difference in V̇o2 max and were selected for further analysis and for a second echocardiography study. Twins were divided into the more (MAG) and less active group (LAG), according to their V̇o2 max. On average, MAG had 18% higher V̇o2 max compared with LAG. In electrocardiography, MAG had 29% ( P = 0.02) higher Cornell voltage and 37% ( P = 0.01) higher right-side hypertrophy index. In echocardiography, no significant differences were observed between the groups, and left ventricular mass index was only 7% ( P = 0.16) higher in MAG. These results show that the volitionally increased physical activity that has led to an 18% increase in cardiorespiratory fitness induces greater changes in electro- than echocardiographic parameters. Electrocardiographic changes were suggestive of left ventricular hypertrophy, and echocardiography showed a similar but statistically nonsignificant trend.

scholarly journals Association of acculturation with cardiac structure and function among Hispanics/Latinos: a cross-sectional analysis of the echocardiographic study of Latinos

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028729 ◽  
Author(s):  
Lenny López ◽  
Katrina Swett ◽  
Fátima Rodriguez ◽  
Jorge R Kizer ◽  
Frank Penedo ◽  
...  
Keyword(s):  
Structure And Function ◽  
Volume Index ◽  
Secondary Outcome ◽  
Cardiac Structure ◽  
Foreign Born ◽  
Cross Sectional ◽  
Echocardiographic Study ◽  
Echocardiographic Assessment ◽  
Cardiac Structure And Function ◽  
And Function

ObjectiveHispanics/Latinos, the largest immigrant population in the USA, undergo the process of acculturation and have a large burden of heart failure risk. Few studies have examined the association of acculturation on cardiac structure and function.DesignCross-sectional.SettingThe Echocardiographic Study of Latinos.Participants1818 Hispanic adult participants with baseline echocardiographic assessment and acculturation measured by the Short Acculturation Scale, nativity, age at immigration, length of US residence, generational status and language.Primary and secondary outcome measuresEchocardiographic assessment of left atrial volume index (LAVI), left ventricular mass index (LVMI), early diastolic transmitral inflow and mitral annular velocities.ResultsThe study population was predominantly Spanish-speaking and foreign-born with mean residence in the US of 22.7 years, mean age of 56.4 years; 50% had hypertension, 28% had diabetes and 44% had a body mass index >30 kg/m2. Multivariable analyses demonstrated higher LAVI with increasing years of US residence. Foreign-born and first-generation participants had higher E/e′ but lower LAVI and e′ velocities compared with the second generation. Higher acculturation and income >$20K were associated with higher LVMI, LAVI and E/e′ but lower e′ velocities. Preferential Spanish-speakers with an income <$20K had a higher E/e′.ConclusionsAcculturation was associated with abnormal cardiac structure and function, with some effect modification by socioeconomic status.

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