02760nas a2200265 4500008004100000022001400041245008600055210006900141260001600210520197300226100001702199700002102216700001902237700002002256700002002276700002402296700001702320700002002337700001902357700002002376700002402396700001802420700002002438856003602458 2023 eng d a2641-765000aCardiac Mechanics and Kidney Function Decline in the Cardiovascular Health Study.0 aCardiac Mechanics and Kidney Function Decline in the Cardiovascu c2023 Mar 083 a

BACKGROUND: Clinical heart failure frequently coexists with chronic kidney disease (CKD) and may precipitate kidney function decline. However, whether earlier-stage myocardial dysfunction assessable by speckle tracking echocardiography is a contributor to kidney function decline remains unknown.

METHODS: We studied 2135 Cardiovascular Health Study (CHS) participants who were free of clinical heart failure and had Year 2-baseline 2D speckle tracking echocardiography and two measurements of estimated glomerular filtration rate (eGFR) (Year 2 and Year 9). "Archival" speckle tracking of digitized echocardiogram videotapes was utilized to measure left ventricular longitudinal strain (LVLS), LV early diastolic strain rate (EDSR), left atrial reservoir strain (LARS), right ventricular free wall strain (RVFWS), and mitral annular velocity (e'). Multivariable Poisson regression models that adjusted for demographics and cardiovascular risk factors were used to investigate the independent associations of cardiac mechanics indices and decline in kidney function defined as a 30% decline in eGFR over 7 years.

RESULTS: In risk factor (RF) models LVLS, EDSR, RVFWS, and e' were all significantly associated with the prevalence of kidney disease. After multivariable adjustment, left atrial dysfunction (RR 1.18 [95% CI 1.01, 1.38] per SD lower LARS] and left ventricular diastolic dysfunction (RR 1.21 [95% CI 1.04, 1.41] per SD lower EDSR) were each significantly associated with 30% decline in eGFR.

CONCLUSIONS: Subclinical myocardial dysfunction suggesting abnormal diastolic function detected by 2D speckle-tracking echocardiography was independently associated with decline in kidney function over time. Further studies are needed to understand the mechanisms of these associations and to test whether interventions that may improve subclinical myocardial dysfunction can prevent decline of kidney function.

1 aMehta, Rupal1 aBůzková, Petra1 aPatel, Harnish1 aCheng, Jeanette1 aKizer, Jorge, R1 aGottdiener, John, S1 aPsaty, Bruce1 aKhan, Sadiya, S1 aIx, Joachim, H1 aIsakova, Tamara1 aShlipak, Michael, G1 aBansal, Nisha1 aShah, Sanjiv, J uhttps://chs-nhlbi.org/node/9320