Relationship between aortic root size and glomerular filtration rate in hypertensive patients

Mulè, Giuseppe; Nardi, Emilio; Morreale, Margherita; D'Amico, S; Foraci, Anna Carola; Nardi, Chiara; Geraci, Giulio; Cerasola, Giovanni; Cottone, Santina

doi:10.1097/hjh.0000000000000819

Cited by 14 publications

(8 citation statements)

References 33 publications

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“…The first important findings of this study are that compared to the patients without DM, those with DM had lower ARD/BSA, and that significantly fewer of the patients with DM had aortic root dilatation. A previous meta-analysis of 8 studies reported that the prevalence of aortic root dilatation in patients with hypertension was around 10%, and that is was even higher in male and elderly patients [20], which is consistent with the study by Mule et al [14]. In our study, the prevalence of aortic root dilatation was higher in the patients without DM than in those with DM.…”

Section: Discussionsupporting

confidence: 92%

“…Only a few studies have investigated the association between renal function and ARD, and the relationship between the rate in the decline of eGFR and ARD is unclear. A previous study on hypertension reported an inverse association between eGFR and ARD [14], and that albuminuria was not correlated with aortic root size [21]. Vascular calcification occurs in patients with CKD, and it is associated with arterial stiffness.…”

Section: Discussionmentioning

confidence: 94%

“…In addition, aortic root dilatation has been reported to be a predictor of left ventricular diastolic dysfunction, and the association between aortic root dilatation and LVH has been demonstrated to be a stronger predictor of CV prognosis than LVH alone [12,13]. Masugata et al reported an inverse association between estimated glomerular filtration rate (eGFR) and aortic root dilatation in patients with hypertension [14], and that DM was inversely correlated with ARD in patients undergoing peritoneal dialysis [15]. However, few studies have investigated correlations among DM, aortic root dilatation and renal function decline in patients with CKD.…”

Section: Introductionmentioning

confidence: 99%

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Aortic Root Dilatation Is Attenuated with Diabetes but Is Not Associated with Renal Progression in Chronic Kidney Disease

Huang

Liu

et al. 2021

JPM

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Patients with chronic kidney disease (CKD) often have cardiac functional and structural abnormalities which can lead to adverse cardiovascular outcomes. In this study, we investigated associations between diabetes mellitus (DM) and cardiac functional and structural parameters in patients with CKD focusing on aortic root diameter (ARD). We also investigated associations of renal outcomes with DM and cardiac functional and structural characteristics. We enrolled 419 patients with CKD stage 3–5 were enrolled. ARD was normalized to body surface area (BSA) (ARD/BSA), and the rate of decline in renal function was assessed by the estimated glomerular filtration rate (eGFR) slope (mL/min/1.73 m2/year). ARD/BSA ≥2.1 cm/m2 in men or ≥2.2 cm/m2 in women was defined as indicating aortic root dilatation. The patients with DM had lower ARD/BSA, higher left atrial dimension (LAD), lower left ventricular ejection fraction, lower ratio of peak early transmitral filling wave velocity to peak late transmitral filling wave velocity, and higher left ventricular relative wall thickness, than those without DM. After multivariable analysis, DM (vs. non-DM; coefficient β, −0.060; p = 0.018) was significantly associated with low ARD/BSA. Significantly fewer patients with DM had aortic root dilatation compared to those without DM (14.3% vs. 23.1%, p = 0.022). In the patients with DM, there were significant associations between a high left ventricular mass index (LVMI) (per 1 g/m2, β, −0.016; p = 0.040) and high LAD (per 1 cm; β, −1.965; p < 0.001) with a low eGFR slope. However, other parameters, including ARD/BSA, were not associated with eGFR slope. Furthermore, there were no associations between eGFR slope and any of the echocardiographic parameters in the patients without DM. Aortic root dilatation was attenuated in the patients with DM, but it was not associated with a decline in renal function. However, high LAD and LVMI were associated with rapid renal function decline in the CKD patients with DM.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Aortic Root Dilatation Is Attenuated with Diabetes but Is Not Associated with Renal Progression in Chronic Kidney Disease

Huang

Liu

et al. 2021

JPM

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“…In a recent study, an inverse correlation between aortic root dimension and estimated glomerular filtration rate was elucidated 4 . An enlarged aortic root, possibly indicating the occurrence of arterial ventricular remodeling, was associated with an increased risk of heart failure 5 .…”

Section: Introductionmentioning

confidence: 99%

Diabetes attenuated age‐related aortic root dilatation in end‐stage renal disease patients receiving peritoneal dialysis

Zhang

et al. 2019

J of Diabetes Invest

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Aims/Introduction Recently, some data have supported the concept that diabetes is negatively associated with aortic aneurysm. In the present study, we aimed to investigate the relationship between diabetes and cardiac structural and functional characteristics, in particular, aortic root dimensions, in end‐stage renal disease (ESRD) patients. Methods ESRD patients receiving peritoneal dialysis for >3 months were consecutively enrolled. Clinical features and echocardiographic parameters were analyzed according to the presence of diabetes history. Correlation analyses were carried out for diabetes mellitus and aortic root dilatation. Multiple logistic regression analysis was carried out to identify variables correlated with aortic root dilatation. Results A total of 218 ESRD patients receiving peritoneal dialysis were enrolled. Patients with diabetes showed lower left ventricular internal measurements in end‐diastole, left ventricular internal measurements in end‐systole and aortic root diameter (ARD)/body surface area (BSA). Worse cardiac diastolic function was also observed in these patients. In addition, the age‐related increase of ARD/BSA and ARD/height was attenuated in patients with diabetes. With the increase of ARD/BSA, lower levels of serum creatinine, phosphorus and serum glucose, as well as higher serum high‐density lipoprotein cholesterol and apolipoprotein A‐1 were also observed. Increased normalized left ventricular internal measurements were shown in patients with greater ARD/BSA. Multiple regression analysis showed that diabetes (odds ratio 0.353, P = 0.015) was an independent correlate of aortic root dilatation, even after correction for age, sex and other clinical confounders in the enrolled patients. Conclusions The present findings shown an inverse association between diabetes and age‐related aortic root dilatation in ESRD patients. Diabetes remained to be independently correlated with aortic root dilatation even after adjustment for age, sex and other clinical confounders in ESRD patients.

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“…Depending on the method, AoR dilation in stage 5 was found in 39% of the patients, when using absolute measurements of the AoR, in 31% of the patients when the AoR was indexed for height, or in 18% of the patients, when using AoR normalized to BSA. 19 In another study, Kaddorauch et al 20 evaluated the effect of impaired renal function on the aortic diameter in 97 pediatric patients (mean age, 11.2 years), including patients on chronic hemodialysis or peritoneal dialysis, and in 19 KTx recipients, who were not analyzed separately. More than 80% of the pediatric patients had hypertension.…”

Section: Methodsmentioning

confidence: 99%

Dilatation of aortic root in patients after kidney transplantation

Obremska¹,

Boratyńska²,

Szymczak³

et al. 2018

Polish Archives of Internal Medicine

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INTRODUCTION Aortic root (AoR) dilation is associated with cardiac damage and higher cardiovascular risk. Cardiovascular disease is the most common cause of death in patients after kidney transplantation (KTx ). OBJECTIVES The aim of this study was to assess the prevalence of enlarged AoR diameter in KTx recipients. Patients with bicuspid aortic valve, significant valvular disease, or evidence of connective tissue disorder were excluded. PATIENTS AND METHODS A total of 87 KTx recipients were divided into 2 groups depending on immunosuppressive regimen: 41 patients receiving mammalian target of rapamycin inhibitors (mTORi) and 46 patients treated with calcineurin inhibitors (CNIs). In all patients, echocardiography was performed, laboratory and clinical markers of cardiovascular risk were assessed, and the AoR diameter was calculated. RESULTS There were no differences between groups in age, sex, body surface area, body mass index, frequency of diabetes, hypertension, dyslipidemia, time after replacement therapy, creatinine levels, and estimated glomerular filtration rate. In the CNI group, the observed and calculated AoR diameters were similar (P = 0.8). In the mTORi group, the observed AoR diameter was higher than the calculated one (P = 0.002). The concentric and eccentric left ventricular hypertrophy was similar in both groups (P = 0.12 and P = 0.69, respectively). In the stepwise regression analysis, the AoR diameter was associated with body surface area and mTORi treatment. CONCLUSIONS KTx recipients have a high prevalence of AoR dilation. Immunosuppressive regimen based on mTORi increases the incidence of AoR enlargement.

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Relationship between aortic root size and glomerular filtration rate in hypertensive patients

Abstract: Our study seems to suggest that a reduced renal function may adversely influence ARD. This may contribute to explain the enhanced cardiovascular risk associated with renal insufficiency.

Cited by 14 publications

References 33 publications

Aortic Root Dilatation Is Attenuated with Diabetes but Is Not Associated with Renal Progression in Chronic Kidney Disease

Aortic Root Dilatation Is Attenuated with Diabetes but Is Not Associated with Renal Progression in Chronic Kidney Disease

Diabetes attenuated age‐related aortic root dilatation in end‐stage renal disease patients receiving peritoneal dialysis

Dilatation of aortic root in patients after kidney transplantation

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