Relationship of Left Ventricular Hypertrophy and Diastolic Function With Cardiovascular and Renal Outcomes in African Americans With Hypertensive Chronic Kidney Disease
| Autor: | Otelio S. Randall, Tudor Vagaonescu, Gail E. Peterson, Miroslaw Smogorzewski, Cynthia Kendrick, Janice P. Lea, Robert A. Phillips, Tom Greene, Gabriel Contreras, Tine De Backer, Lawrence J. Appel, Xuelei Wang |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Diastole Kidney Left ventricular hypertrophy Muscle hypertrophy Cohort Studies Ventricular Dysfunction Left chemistry.chemical_compound Risk Factors Internal medicine Internal Medicine medicine Humans Renal Insufficiency Chronic Aged Ultrasonography Creatinine business.industry Diastolic heart failure Middle Aged Prognosis medicine.disease Black or African American chemistry Cardiovascular Diseases Heart failure Hypertension Cardiology Female Hypertrophy Left Ventricular business Cohort study Kidney disease |
| Zdroj: | Hypertension. 62:518-525 |
| ISSN: | 1524-4563 0194-911X |
| DOI: | 10.1161/hypertensionaha.111.00904 |
| Popis: | African Americans with hypertension are at high risk for adverse outcomes from cardiovascular and renal disease. Patients with stage 3 or greater chronic kidney disease have a high prevalence of left ventricular (LV) hypertrophy and diastolic dysfunction. Our goal was to study prospectively the relationships of LV mass and diastolic function with subsequent cardiovascular and renal outcomes in the African American Study of Kidney Disease and Hypertension cohort study. Of 691 patients enrolled in the cohort, 578 had interpretable echocardiograms and complete relevant clinical data. Exposures were LV hypertrophy and diastolic parameters. Outcomes were cardiovascular events requiring hospitalization or causing death; a renal composite outcome of doubling of serum creatinine or end-stage renal disease (censoring death); and heart failure. We found strong independent relationships between LV hypertrophy and subsequent cardiovascular (hazard ratio, 1.16; 95% confidence interval, 1.05–1.27) events, but not renal outcomes. After adjustment for LV mass and clinical variables, lower systolic tissue Doppler velocities and diastolic parameters reflecting a less compliant LV (shorter deceleration time and abnormal E/A ratio) were significantly ( P |
| Databáze: | OpenAIRE |
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