Echocardiography-Based Cardiac Structure Parameters for the Long-term Risk of End-Stage Kidney Disease in Black Individuals: The Atherosclerosis Risk in Communities Study.
Echocardiography-Based Cardiac Structure Parameters for the Long-term Risk of End-Stage Kidney Disease in Black Individuals: The Atherosclerosis Risk in Communities Study.
复制标题
基于超声心动图的心脏结构参数对黑人终末期肾病长期风险的影响：社区研究中的动脉粥样硬化风险。
DOI：
10.1016/j.mayocp.2022.06.018
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发表时间：
2022
影响因子：
8.9
通讯作者：
Ishigami,Junichi
中科院分区：
文献类型：
--
作者：
Kou,Minghao;Hishida,Manabu;Mathews,Lena;Kitzman,DalaneW;Shah,AmilM;Coresh,Josef;Solomon,Scott;Matsushita,Kunihiro;Ishigami,Junichi
目的评价超声心动图左心室(LV)结构和功能参数是否与终末期肾病(ESKD)发生的长期风险有关。患者与方法我们从1993年1月1日至2017年7月31日对来自杰克逊社区动脉粥样硬化风险研究的2137名黑人参与者进行了前瞻性队列研究。对1993~1995年超声心动图测量的左心室结构和功能参数进行了分析。主要结果事件ESKD是通过与美国肾脏数据系统的联系确定的。结果在22.2(四分位数间隔15.0-23.3)年的中位随访期内，共有117例ESKD病例发生。多变量COX模型显示，较高的LV质量指数与ESKD的风险显著相关(HR，2.38；95%CI，最高四分位数与最低四分位数比较，1.21~4.68，P=0.012)。当使用收缩末期(HR最高与最低四分位的HR，4.38；95%CI，1.94~9.92，P&0.001)与舒张末(HR，3.5；95%CI，1.53~8.01，P=0.003)时，左室后壁厚度的HR显著或更高，且HR略高。结论在居住在该社区的黑人中，包括室壁厚度在内的超声心动图参数与随后发生ESKD的风险密切相关。这些结果对新的左室结构异常者的预防和治疗策略具有潜在的指导意义。
ObjectiveTo assess whether echocardiographic parameters of left ventricular (LV) structure and function relate to the long-term risk of incident end-stage kidney disease (ESKD).Patients and MethodsWe conducted a prospective cohort study analyzing 2137 Black participants from the Jackson site of the Atherosclerosis Risk in Communities Study from January 1, 1993, through July 31, 2017. Echocardiographic parameters of LV structure and function were obtained from 1993 to 1995. The primary outcome incident ESKD was identified through the linkage to the United States Renal Data System. Cox proportional hazards models were used to estimate the hazard ratios (HRs) according to each echocardiographic parameter.ResultsThere were 117 incident ESKD cases during a median follow-up of 22.2 (interquartile range, 15.0-23.3) years. Multivariable Cox models revealed that a higher LV mass index was significantly associated with the risk of ESKD (HR, 2.38; 95% CI, 1.21 to 4.68 for highest vs lowest quartile,P= 0.012). The HRs were significant and even higher for LV posterior wall thickness, with slightly higher HRs when their measures in end-systole (HR for highest vs lowest quartile, 4.38; 95% CI, 1.94 to 9.92,P< 0.001) vs end-diastole (HR, 3.50; 95% CI, 1.53 to 8.01,P= 0.003) were used. The associations were not significant for LV function parameters.ConclusionIn Black individuals residing in the community, echocardiographic parameters of LV structure, including LV wall thickness, were robustly associated with the risk of subsequently incident ESKD. These results have potential implications for novel prevention and management strategies for persons with abnormal LV structure.