The association between renal impairment and cardiac structure and function in patients with acute myocardial infarction

Background Renal dysfunction in patients with acute myocardial infarction (MI) is an important predictor of short- and long-term outcome. Cardiac abnormalities dominated by left ventricular (LV) hypertrophy are common in patients with chronic renal dysfunction. However, limited data exists on the as...

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Bibliographic Details
Published in:The American heart journal 2014-04, Vol.167 (4), p.506-513
Main Authors: Ersbøll, Mads, MD, Valeur, Nana, MD, PhD, Hassager, Christian, MD, DSci, Søgaard, Peter, MD, DSci, Køber, Lars, MD, DSci
Format: Article
Language:English
Subjects:
Aged
Algorithms
Cardiovascular
Coronary vessels
Diabetes
Echocardiography, Doppler
Female
Follow-Up Studies
Glomerular Filtration Rate
Heart attacks
Heart Ventricles - diagnostic imaging
Heart Ventricles - physiopathology
Hospitalization
Humans
Hypertension
Male
Medical imaging
Middle Aged
Mortality
Myocardial Infarction - complications
Myocardial Infarction - diagnosis
Myocardial Infarction - physiopathology
Patients
Prognosis
Prospective Studies
Renal Insufficiency - etiology
Renal Insufficiency - physiopathology
Severity of Illness Index
Studies
Veins & arteries
Ventricular Function, Left - physiology
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Summary:Background Renal dysfunction in patients with acute myocardial infarction (MI) is an important predictor of short- and long-term outcome. Cardiac abnormalities dominated by left ventricular (LV) hypertrophy are common in patients with chronic renal dysfunction. However, limited data exists on the association between LV systolic- and diastolic function assessed by comprehensive echocardiography and renal dysfunction in contemporary unselected patients with acute MI. Methods We prospectively included 1054 patients with acute MI (mean age 63 years, 73% male) and performed echocardiographic assessment of systolic and diastolic function within 48 hours of admission as well as estimated glomerular filtration rate (eGFR). Results Reduced eGFR was significantly associated with LV mass, LV ejection fraction, LV global strain (GLS) and E/e′ ratio. After multivariable adjustment, E/e′ ratio ( P = .0096) remained the only echocardiographic measure independently associated with decreasing eGFR. During follow-up a total of 113 patients (10.7%) patients experienced the composite endpoint of all-cause mortality or hospitalization for heart failure. An eGFR 1, multivessel disease and troponin. The prognostic impact of an eGFR
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2013.12.029