Original Contribution
Figure 1: Correlation Between Early to Late Diastolic Peak Velocity (E/A) Ratio and Urine Albumin to Creatinine Ratio (UACR) (R=-0.192, p=0.038)
100.00
The American Heart Hospital Journal
Table 3: Association Between Early to Late Diastolic Peak Velocity (E/A) Ratio and Appearance of Microalbuminuria with the Presence of Cofounders
Variables
Beta Standard p Value Error
Appearance of microalbuminuria 0.138 0.104 0.185 Male gender Advanced age
Body mass index 80.00
Duration of hypertension Systolic BP at admission Diastolic BP at admission
60.00 BP = blood pressure. 40.00 20.00
serum creatinine was 112.47 ± 62.96 mmol/l and mean UACR was 15.58 ± 21.85 mg/mmol. No significant differences were observed between the two groups with and without microalbuminuria in terms of baseline characteristics, oral medications, first measured blood pressures at admission, and serum lipid profile and fasting blood sugar.
0.00 0.50 1.00
1.50 E/A
2.00 2.50
categorical variables across the groups were performed using an overall chi-square test or Fisher's exact test if required. Comparisons of continuous variables were performed using an independent t test. Descriptive statistics, including sensitivity and specificity of UACR, in determining the presence or exclusion of significant acute coronary syndrome were calculated. Receiver operator characteristic (ROC) curves were constructed to investigate the diagnostic power of the variable. The cut-off score was estimated for prediction of LVH by the ROC curve analysis (the empirical point that maximizes sensitivity and specificity of the UACR level for predicting LVH). p Values of 0.05 or less were considered statistically significant. All the statistical analyses were performed using SPSS version 13 (SPSS Inc., Chicago, IL) and the STATA statistical package (version 10.0; College Station, TX).
Results
Descriptive data of the participants are presented in Table 1. The mean age of patients was 53 ± 11 years and 41.7 % were men. UACR was measured in all patients and microalbuminuria was found in seven patients (5.6 %). Mean sitting systolic and diastolic blood pressures at admission were 143.17 ± 18.64 and 88.48 ± 9.37 mmHg and mean body mass index was 29.66 ± 4.54 kg/m2. Mean
92 Discussion
This study provided the first assessment of the association between microalbuminuria and LV geometric patterns, and systolic and diastolic LV function in a sample of Iranian patients with essential hypertension without apparent renal failure. The first important finding was that the prevalence of microalbuminuria in patients with primary
Urine Albumin to Creatinine Ratio and Echocardiographic Left Ventricular Structure and Function in Patients with Hypertension Winter 2011
Measures of LV structure and systolic and diastolic LV function are summarized in Table 2 and compared across the two groups. UACR was significantly no different in patients with LVH than in patients with normal LV geometry (21.26 ± 31.55 versus 17.80 ± 24.52 mg/mmol, p=0.776). Among LV systolic and diastolic parameters, only E/A ratio was univariately higher in the group without microalbuminuria, however the E/A ratio index was similar between the groups with and without microalbuminuria adjusted for demographics, duration of hypertension, and blood pressures measurements (Table 3). No significant correlation was found between UACR measurement and systolic and diastolic function parameters, including E/A ratio (R=-0.192, p=0.038), E/E’ ratio (R=-0.025, p=0.794), LV ejection fraction (R=0.008, p=0.929), and LV mass (R=-0.132, p=0.154) (Figures 1 and 2).
According to the ROC curve analysis, UACR measurement was not an acceptable indicator of LVH with areas under the ROC curves 0.514 (95 % confidence interval [CI] 0.394–0.634). The optimal cut-off value for UACR for predicting LVH was identified at 9.4, yielding a sensitivity of 51.6 % and a specificity of 48.3 %.
0.130 0.065 0.050 -0.016 0.003 <0.001 -0.006 0.007 0.360 0.001 0.001 0.683 0.003 0.002 0.165 -0.007 0.005 0.128
UACR
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