Early cardio-renal interactions among apparently healthy individuals undergoing coronary CT. (1st August 2020)

• Record Type: Journal Article
• Authors: Rozenbaum, Zach; Atlan, Lilian; Taieb, Philippe; Shalmon, Tamar; Berliner, Shlomo; Arbel, Yaron; Aviram, Galit
• Is Part Of: International journal of cardiology. Volume 312(2020)
• Page Start: 117
• Page End: 122
• Publication Date: 2020-08-01
• Subjects: Cardiac chambers -- Left atrial volume -- Volumetry -- Cardio-renal syndrome; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2020.02.041
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Previously we found that cardiac chambers' volumes correlate with estimated glomerular filtration rate (eGFR) of hospitalized patients. Currently we aimed to demonstrate this relation among apparently healthy individuals. Methods: Ambulatory participants who underwent electrocardiography-gated cardiac computed tomography angiography (CCTA) were included. Subjects with an eGFR<60 ml/min/1.73m 2, cardiovascular risk factors, and co-morbidities or medications which may influence cardiac chambers' volumes were excluded. Chambers' sizes were obtained by automatic four chamber volumetric analysis of the CCTAs, and calcium score was assessed using the Agatston score. Results: The cohort consisted of 89 apparently healthy individuals, mostly of male gender (70%), with a mean age of 51 years and a mean eGFR of 79.5 ml/min/1.73m 2 . A low calcium score (≤10HU) was found in 67.4%( n = 60) of the cohort. After adjustment for baseline characteristics, renal function was associated exclusively with the volume of the left atrium (LA; b-coefficient-0.15, 95%CI -0.3- -0.01, p = .041). A 15.9% (95%CI 0.3–33.9%, p = .045) increase in LA volume index (LAVI) was found among participants with eGFR of 80–90 when compared to those with eGFR>90 ml/min/1.73m 2 . Participants with a low calcium score showed an increase in LAVI only when eGFR was reduced from normal (>90 ml/min/1.73m 2 ) to 70-80 ml/min/1.73m 2 (and not to 80-90 ml/min/1.73m 2 ), revealing a percentage increase of 24.7% (95%CI 5.5–47.4%, p = .011). Conclusions: Renal function is closely related to LA volume even in the absence of overt renal failure, demonstrating that minor changes in eGFR instigate an increase in volumes. Risk factors for this interaction should be identified and treated prior to the development of cardio-renal syndrome. Highlights: Cardiorenal interactions were investigated among apparently healthy individuals. LA volume increased by 15% when eGFR was reduced from 90 to 80 ml/min/1.73m 2 . Including only patients with a low calcium score did no eliminate the relation. Volumetric analyses may possibly detect signs prior to a cardio-renal syndrome.