CKD Patients with Left Atrial Enlargement at Risk of Heart Failure

CKD Patients with Left Atrial Enlargement at Risk of Heart Failure

New findings from the Chronic Renal Insufficiency Cohort (CRIC) study analysis revealed that the size of the heart’s left atrium in chronic kidney disease patients is a risk marker for heart failure. The data, from researchers at the Perelman School of Medicine at the University of Pennsylvania, were presented at the American Heart Association Scientific Sessions 2015, Nov. 7–11, in Orlando, Florida.

Chronic kidney disease (CKD) is a condition characterized by the progressive loss of kidney function. Its main causes are diabetes and high blood pressure (hypertension), disorders that account for two-thirds of all CKD cases. According to the National Kidney Foundation, chronic kidney disease affects approximately 26 million American adults.

CKD patients present, in general, a high risk of heart disease and cardiovascular events, but no markers have been identified to predict which patients are at higher risk and merit more urgent medical care and prevention. To develop improved tools for CDK patient risk-stratification, researchers analyzed CRIC data collected from 2,936 CKD patients. The team focused on the size of patients’ left atrium (one of the two top chambers in the heart), a cardiac characteristic commonly used as a predictor of cardiovascular disease and related mortality, leading researchers to theorize it could also be used to predict the same events in CDK patients. Upon data analysis and after adjustments to other markers of heart disease risk such as race, gender and hypertension, researchers observed that enlargement of the left atrium of the heart was indeed a risk marker for heart failure in patients with chronic kidney disease.

In a press release, Dr. Payman Zamani, MD, heart failure physician and instructor of Medicine in Penn’s Heart Failure and Transplant Cardiology Program and lead author of the study, explained the study’s objectives and results: “One of the main purposes of the CRIC study is to identify novel risk factors for cardiovascular events in CKD patients. We know that patients with CKD are at high-risk for cardiovascular events in general, but we need better tools to identify which CKD patients are at the highest risk.

“Left atrial size is an easily quantifiable metric that provides prognostic information in non-CKD patients, so we evaluated this patient population to determine if it is also an indicator of risk in those with CKD. Our analysis shows that larger left atrial size is associated with an increased risk of heart failure.”

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