成人慢性肾脏病患者与非患者左心室几何形态的对比分析：伊巴丹 CRECKID 研究结果。

Comparative Analysis of Left Ventricular Geometry in Adult Nigerians with and without Chronic Kidney Disease: Results from Ibadan CRECKID STUDY.

机构信息

Department of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.

Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria.

出版信息

West Afr J Med. 2022 Apr 29;39(4):336-342.

PMID:35488873

Abstract

BACKGROUND

Chronic kidney disease (CKD) is associated with increased risk of cardiovascular morbidity and mortality. Left ventricular hypertrophy (LVH) is considered the strongest independent predictor of cardiovascular disease and events among CKD patients. We reported the echocardiographic left ventricular geometry in CKD patients compared to non-CKD hypertensive and apparently healthy controls in Ibadan.

MATERIALS AND METHODS

A total of 683 participants in the CRECKID STUDY comprising 220(32.2%) CKD patients, 281(41.1%) non-CKD hypertensive patients and 182(26.6%) healthy controls were included in this analysis. Basic demographic and clinical information with echocardiographic parameters were obtained.

RESULTS

Study participants in the non-CKD hypertensive group were on average older than the CKD and the healthy controls (56.2±13.1 vs 47.2±14.6, and 46.8±13.3 years, respectively; p<0.01). Compared with other groups, greater proportions of participants with CKD were men (40.5% vs.38.1% and 21.3%; p<0.0001). The left atrial and left ventricular dimensions were significantly higher in CKD compared with others. LVH was significantly more prevalent among CKD patients (68.2%) compared to hypertensive (43.9%) and normotensive (19.5%) group (p<0.01). The participants with CKD had a greater proportion of abnormal LV geometry with concentric LVH predominating (p<0.0001). Having LVH was associated with lower mean estimated glomerular filtration rate (eGFR) (40.6±37.71 vs 67±37.38, p<0.0001).

CONCLUSION

In our study, patients with CKD had the highest prevalence of abnormal LV geometry and functions. A unit decrease in eGFR was associated with increased left ventricular mass. Early detection and prompt management of abnormal LV geometry may help in reducing adverse cardiovascular outcome in patients with CKD.

摘要

背景

慢性肾脏病（CKD）与心血管发病率和死亡率的增加相关。左心室肥厚（LVH）被认为是 CKD 患者心血管疾病和事件的最强独立预测因子。我们在伊巴丹报告了 CKD 患者与非 CKD 高血压和明显健康对照组相比的超声心动图左心室几何结构。

材料和方法

共有 683 名参与 CRECKID 研究的参与者，包括 220 名（32.2%）CKD 患者、281 名（41.1%）非 CKD 高血压患者和 182 名（26.6%）健康对照者，纳入本分析。获得了基本的人口统计学和临床信息以及超声心动图参数。

结果

非 CKD 高血压组的研究参与者平均年龄大于 CKD 和健康对照组（56.2±13.1 岁比 47.2±14.6 岁和 46.8±13.3 岁，分别；p<0.01）。与其他组相比，CKD 组中更多的参与者为男性（40.5%比 38.1%和 21.3%；p<0.0001）。与其他组相比，CKD 患者的左心房和左心室尺寸明显更高。与高血压（43.9%）和正常血压（19.5%）组相比，CKD 患者的 LVH 更为普遍（p<0.01）。CKD 患者的异常 LV 几何结构比例更高，以向心性 LVH 为主（p<0.0001）。LVH 与平均估算肾小球滤过率（eGFR）降低相关（40.6±37.71 比 67±37.38，p<0.0001）。