Early cardio-renal interactions among apparently healthy individuals undergoing coronary CT

Zach Rozenbaum, Lilian Atlan, Philippe Taieb, Tamar Shalmon, Shlomo Berliner, Yaron Arbel, Galit Aviram

Research output: Contribution to journalArticlepeer-review

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/1.73m2, 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/1.73m2. 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/1.73m2. Participants with a low calcium score showed an increase in LAVI only when eGFR was reduced from normal (>90 ml/min/1.73m2) to 70-80 ml/min/1.73m2 (and not to 80-90 ml/min/1.73m2), 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.

Original languageEnglish
Pages (from-to)117-122
Number of pages6
JournalInternational Journal of Cardiology
Volume312
DOIs
StatePublished - 1 Aug 2020

Keywords

  • Cardiac chambers
  • Cardio-renal syndrome
  • Left atrial volume
  • Volumetry

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