Abstract: FR-PO758
Fasting Plasma Glucose and Glycated Hemoglobin Are Associated With Posterior Wall Thickness and Left Atrial Diameter in Patients With CKD
Session Information
- Hypertension and CVD: Clinical, Outcomes, Trials
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1502 Hypertension and CVD: Clinical‚ Outcomes‚ and Trials
Authors
- Borges Canha, Marta, Centro Hospitalar Universitario de Sao Joao, Porto, Porto, Portugal
- Marques, Mariana Fragao, Centro Hospitalar Universitario de Sao Joao, Porto, Porto, Portugal
- Neves, João Sérgio, Centro Hospitalar Universitario de Sao Joao, Porto, Porto, Portugal
- Ravi, Katherine Scovner, Brigham and Women's Hospital, Boston, Massachusetts, United States
- McCausland, Finnian R., Brigham and Women's Hospital, Boston, Massachusetts, United States
Background
Cardiovascular (CV) disease is the major cause of death in patients with chronic kidney disease (CKD), particularly among patients with diabetes. Several echocardiographic parameters are known to predict CV events and death in patients with CKD, but data on the association of glycemic metabolism with echocardiographic parameters in CKD is scarce.
Methods
Using the Chronic Renal Insufficiency Cohort (CRIC) Study, we excluded patients with baseline heart failure, missing fasting plasma glucose (FPG) or glycated hemoglobin (A1c) measurements, or echocardiography data at year 1 (2557 included patients). We used restricted cubic splines to assess the association of FPG and A1c with: left ventricular mass (LVM); posterior wall thickness (PWT); interventricular septal thickness in diastole (IVSTD); LV internal diameter in diastole and systole (LVIDD and LVIDS); left atrial diameter (LAD); LV ejection fraction (LVEF); A wave duration; E wave velocity and E/A wave ratio. Models were adjusted for age, sex, race, body mass index, systolic blood pressure, heart rate, history of peripheral vascular disease, stroke, myocardial infarction or prior revascularization, antiplatelet, lipid lowering or inhibition of renin-angiotensin-aldosterone axis therapy, hematocrit, serum albumin, baseline estimated glomerular filtration rate (CKD-EPI formula) and 24-hour urine protein excretion (log-transformed).
Results
Patients within higher FPG or A1c quartiles are more likely to be males, older, black, and to have medical history of coronary artery disease, stroke, and peripheral vascular disease. These patients have higher PWT, IVSTD, LV mass and LAD, and lower E/A ratio. The spline analyses show that higher FPG and A1c are associated with higher PWT, and that higher FPG is associated to higher LAD (Figure 1).
Conclusion
Among patients with CKD, higher FPG and A1c are independently associated with higher PWT, and higher FPG is positively associated to LAD. Whether interventions that improve glycaemic control can result in regression of these parameters is not clear.