2014
DOI: 10.1016/j.jchf.2014.05.016
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Albuminuria Is Independently Associated With Cardiac Remodeling, Abnormal Right and Left Ventricular Function, and Worse Outcomes in Heart Failure With Preserved Ejection Fraction

Abstract: Objectives To determine the relationship between albuminuria and cardiac structure/function in heart failure with preserved ejection fraction (HFpEF). Background Albuminuria, a marker of endothelial dysfunction, has been associated with adverse cardiovascular outcomes in HFpEF. However, the relationship between albuminuria and cardiac structure/function in HFpEF has not been well studied. Methods We measured urinary albumin-to-creatinine ratio (UACR) and performed comprehensive echocardiography, including … Show more

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Cited by 76 publications
(64 citation statements)
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“…(38, 39) Recent work by Shah and colleagues has shown that RV remodeling is an independent prognostic factor in HFpEF; (40) in the same cohort, microalbuminuria (a marker of endothelial dysfunction) was associated with RV remodeling independent of comorbidities and LV mass. (41) To our knowledge, the association of VTI with RV function that we observed has not been demonstrated previously in CKD or non-CKD populations. Notably, the association between VTI and RV dysfunction persists even in the smaller subgroup without self-reported atherosclerotic disease and in the whole group after adjustment for medications.…”
Section: Discussionsupporting
confidence: 39%
“…(38, 39) Recent work by Shah and colleagues has shown that RV remodeling is an independent prognostic factor in HFpEF; (40) in the same cohort, microalbuminuria (a marker of endothelial dysfunction) was associated with RV remodeling independent of comorbidities and LV mass. (41) To our knowledge, the association of VTI with RV function that we observed has not been demonstrated previously in CKD or non-CKD populations. Notably, the association between VTI and RV dysfunction persists even in the smaller subgroup without self-reported atherosclerotic disease and in the whole group after adjustment for medications.…”
Section: Discussionsupporting
confidence: 39%
“…Still, the strong relationship between proteinuria and decreased survival has been repeatedly demonstrated in both heart failure with preserved EF and more current HF populations suggesting these results are still relevant in today’s practice. 15, 32 The SOLVD trial was not originally designed to investigate associations between proteinuria and renal function and as such, physicians were not blinded to BUN, creatinine or presence of proteinuria. Moreover, non-neurohormonal factors such as protein catabolism and diet that are known to influence urea absorption may have led to uncontrolled confounding.…”
Section: Discussionmentioning
confidence: 99%
“…Furthermore, albuminuria is correlated with left ventricular (LV) diastolic dysfunction . The association between albuminuria and LV systolic function has been assessed via two‐dimensional speckle‐tracking echocardiography (2DSTE) in such conditions as DM, hypertension, and heart failure with a preserved ejection fraction . Research has shown a relation between albuminuria and subtly impaired LV systolic function.…”
Section: Introductionmentioning
confidence: 99%