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Association of Albuminuria With Cardiac Dysfunction in US Hispanics/Latinos.

TitleAssociation of Albuminuria With Cardiac Dysfunction in US Hispanics/Latinos.
Publication TypePublication
Year2017
AuthorsHanna DB, Xu S, Melamed ML, Gonzalez F, Allison MA, Bilsker MS, Hurwitz BE, Kansal MM, Schneiderman N, Shah SJ, Kaplan RC, Rodriguez CJ, Kizer JR
JournalAm J Cardiol
Volume119
Issue12
Pagination2073-2080
Date Published2017 06 15
ISSN1879-1913
Keywordsalbuminuria, Biomarkers, Creatinine, Diastole, Disease Progression, Echocardiography, Female, Heart Ventricles, Hispanic Americans, Humans, Male, Middle Aged, Prevalence, Retrospective Studies, Systole, United States, Ventricular Dysfunction, Left, Ventricular Remodeling
Abstract

Higher urine albumin-to-creatinine ratio (UACR) has been associated with cardiac dysfunction in the general population. We assessed the association of UACR with cardiac structure and function in the Echocardiographic Study of Latinos (Echo-SOL), an ancillary study of the Hispanic Community Health Study/Study of Latinos across 4 US sites. Echo-SOL participants underwent standard 2-dimensional echocardiography, including speckle-tracking strain analysis. UACR was categorized as normal and high-normal (based on the midpoint of values below microalbuminuria), microalbuminuria (≥17 mg/g for men; ≥25 mg/g for women), and macroalbuminuria (≥250 mg/g; ≥355 mg/g). Simultaneous assessments were made of left ventricular (LV) mass index and hypertrophy and measures of LV systolic and diastolic dysfunction. We assessed the association of UACR with subclinical cardiac measures, adjusting for sociodemographic and cardiometabolic factors. Among 1,815 participants (median age 54, women 65%), 42% had normal UACR, 43% high-normal UACR, 13% microalbuminuria, and 2% macroalbuminuria. Prevalence of LV hypertrophy was 13%, LV systolic dysfunction (ejection fraction <50%) 3%, and diastolic dysfunction 53%. After covariate adjustment, both micro- and macroalbuminuria were significantly associated with a twofold increase in LV hypertrophy. Microalbuminuria but not macroalbuminuria was associated with worse global longitudinal strain. Elevated UACR, even at high-normal levels, was significantly associated with greater diastolic dysfunction. In conclusion, elevated UACR was associated with LV hypertrophy and diastolic dysfunction in the largest known population sample of US Hispanic/Latinos. Screening and detection of even high-normal UACR could be of value to guide cardiovascular disease prevention efforts among Hispanic/Latino Americans.

DOI10.1016/j.amjcard.2017.03.039
Alternate JournalAm J Cardiol
PubMed ID28438309
PubMed Central IDPMC5609841
Grant ListR01 HL104199 / HL / NHLBI NIH HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
MS#: 
0325
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Bronx (Einstein College of Medicine)
ECI: 
Yes
Manuscript Affiliation: 
Field Center: Bronx (Einstein College of Medicine)
Manuscript Status: 
Published and Public