Regional left ventricular function in individuals with mild to moderate renal insufficiency: The Multi-Ethnic Study of Atherosclerosis

Introduction Asymptomatic individuals with moderate reduction in renal function are at increased risk for congestive heart failure. In this study we investigate the relationship between mild-moderate renal insufficiency and regional left ventricle function in a population free of cardiovascular disease. Method This is a cross-sectional study in 500 individuals ≥45 years of age without known cardiovascular disease who participated in the Multi-Ethnic Study of Atherosclerosis. Regional systolic and diastolic strain rate as well as peak systolic midwall circumferential strain were calculated from tagged magnetic resonance imaging studies in these participants. Regions were defined by coronary territories (left anterior descending, left circumflex, right coronary artery). Creatinine clearance (CrCl) was estimated by using the Cockcroft-Gault equation and categorized as ≥90 mL/min (normal CrCl), 60 to 89 mL/min (mildly reduced CrCl), and <60 mL/min (moderately reduced CrCl). Results The mean participant age was 66 ± 10 years (58% men). The mean CrCl was 80 ± 25 mL/min. Multiple linear regression analyses indicated that circumferential systolic strain as well as systolic strain rate were significantly lower in participants with moderately reduced CrCl compared with those with normal CrCl in all coronary territories. Lower diastolic strain rates was observed in mild-moderate renal territories compared with those with normal CrCl. Conclusions Impaired regional systolic and diastolic function was observed with mild-moderate reduction of renal function without evidence of clinical heart disease. The results strengthen the usefulness of routine determination of renal function in potentially identify individuals with early myocardial dysfunction.