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Am J Cardiol. 2017 Jun 15;119(12):2073-2080. doi: 10.1016/j.amjcard.2017.03.039. Epub 2017 Mar 29.

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

Author information

1
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
2
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.
3
Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
4
Department of Family Medicine and Public Health, University of California-San Diego, La Jolla, California.
5
Department of Medicine, University of Miami, Miami, Florida.
6
Department of Medicine, University of Miami, Miami, Florida; Department of Psychology, University of Miami, Miami, Florida.
7
Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
8
Department of Medicine, Northwestern University, Chicago, Illinois.
9
Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina; Department of Epidemiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Electronic address: crodrigu@wakehealth.edu.

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.

PMID:
28438309
PMCID:
PMC5609841
DOI:
10.1016/j.amjcard.2017.03.039
[Indexed for MEDLINE]
Free PMC Article

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