Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Abstract

Background and Aims

Albuminuria signifies subclinical vascular damage in the kidneys and other organs and is associated with systemic endothelial dysfunction and increased future cardiovascular risk.

Subendocardial viability ratio (SEVR) is defined as diastolic to systolic pressure-time integral ratio and is a marker of subendocardial perfusion. Reduced SEVR has been uncovered in patients with chronic kidney disease (CKD) and simultaneous albuminuria. Albuminuria is also considered a risk factor for peripheral artery disease, especially in patients with additional atherosclerosis risk factors or diabetes mellitus. The aim of our study was to determine the impact of albuminuria on SEVR and ankle-brachial index (ABI) in patients without known CKD.

Method

We included 111 patients (73% male, mean age 64.2±9.3 years) that were hospitalized at our Cardiology department between 2016-2020 due to elective cardiac catheterization. Albuminuria was determined by urine albumin to creatinine ratio (UACR) from a random urine specimen. SEVR was determined by using applanation tonometry on radial artery (Sphygmocor, Atcor Medical, Australia). Ankle-brachial index (ABI) was measured by using an automated, non-invasive waveform analysis device (MESIÒ, Slovenia), mean ABI between the left and right side was used. Glomerular filtration rate was estimated (eGFR) by using the CKD-EPI 2009 creatinine equation. All the data were obtained prior to cardiac catheterization and only patients with eGFR ³60 ml/min/1.73 m2 were included. Statistical analysis was performed with the Statistical Package for Social Sciences version 22.0 (SPSS Inc, USA).

Results

Basic descriptive statistics, comorbidities, and medications are presented in Tables 1 and 2. Spearmann's correlation test showed significant correlation between UACR and SEVR (r = - 0.238; p = 0.017) and UACR and ABI (r = - 0.304; p = 0.003). Multiple regression analysis with SEVR as the dependent variable and waist-to-hip ratio, body mass index (BMI), arterial hypertension, diabetes, dyslipidemia, eGFR and UACR as independent variables, showed a significant association between UACR and SEVR (b = - 0.232; p = 0.029). The same model was used for ABI as the dependent variable, and a significant association was found only between UACR and ABI (b = - 0.232; p = 0.029).

Conclusion

Albuminuria is independently associated with decreased SEVR and ABI even in the absence of CKD.

Table 1:
Open in new tab

Basic descriptive statistics of included patients (n = 111).

ParameterMean ± standard deviationRange
Age (years)64.2 ± 9.327 – 82
Body Mass Index – BMI (kg/m2)28.3 ± 4.318.9 – 37.8
Waist-to-hip ratio1.0 ± 0.10.8 – 1.1
Hemoglobin (g/L)140.8 ± 12.998 – 171
C-reactive protein (mg/L)4.9 ± 7.03 – 55
Creatinine (μmol/L)77.6 ± 14.049 – 108
Estimated glomerular filtration rate – eGFR (ml/min/1.73 m2)81.3 ± 9.462 – 90
Urinary albumin-to-creatinine ratio – UACR (mcg/mg)20.1 ± 22.40 – 154
Mean ankle-brachial index – ABI1.1 ± 0.10.8 – 1.3
Subendocardial viability ratio – SEVR (%)165.9 ± 36.192 – 299
ParameterMean ± standard deviationRange
Age (years)64.2 ± 9.327 – 82
Body Mass Index – BMI (kg/m2)28.3 ± 4.318.9 – 37.8
Waist-to-hip ratio1.0 ± 0.10.8 – 1.1
Hemoglobin (g/L)140.8 ± 12.998 – 171
C-reactive protein (mg/L)4.9 ± 7.03 – 55
Creatinine (μmol/L)77.6 ± 14.049 – 108
Estimated glomerular filtration rate – eGFR (ml/min/1.73 m2)81.3 ± 9.462 – 90
Urinary albumin-to-creatinine ratio – UACR (mcg/mg)20.1 ± 22.40 – 154
Mean ankle-brachial index – ABI1.1 ± 0.10.8 – 1.3
Subendocardial viability ratio – SEVR (%)165.9 ± 36.192 – 299
Table 1:
Open in new tab

Basic descriptive statistics of included patients (n = 111).

ParameterMean ± standard deviationRange
Age (years)64.2 ± 9.327 – 82
Body Mass Index – BMI (kg/m2)28.3 ± 4.318.9 – 37.8
Waist-to-hip ratio1.0 ± 0.10.8 – 1.1
Hemoglobin (g/L)140.8 ± 12.998 – 171
C-reactive protein (mg/L)4.9 ± 7.03 – 55
Creatinine (μmol/L)77.6 ± 14.049 – 108
Estimated glomerular filtration rate – eGFR (ml/min/1.73 m2)81.3 ± 9.462 – 90
Urinary albumin-to-creatinine ratio – UACR (mcg/mg)20.1 ± 22.40 – 154
Mean ankle-brachial index – ABI1.1 ± 0.10.8 – 1.3
Subendocardial viability ratio – SEVR (%)165.9 ± 36.192 – 299
ParameterMean ± standard deviationRange
Age (years)64.2 ± 9.327 – 82
Body Mass Index – BMI (kg/m2)28.3 ± 4.318.9 – 37.8
Waist-to-hip ratio1.0 ± 0.10.8 – 1.1
Hemoglobin (g/L)140.8 ± 12.998 – 171
C-reactive protein (mg/L)4.9 ± 7.03 – 55
Creatinine (μmol/L)77.6 ± 14.049 – 108
Estimated glomerular filtration rate – eGFR (ml/min/1.73 m2)81.3 ± 9.462 – 90
Urinary albumin-to-creatinine ratio – UACR (mcg/mg)20.1 ± 22.40 – 154
Mean ankle-brachial index – ABI1.1 ± 0.10.8 – 1.3
Subendocardial viability ratio – SEVR (%)165.9 ± 36.192 – 299
Table 2:
Open in new tab

Most common comorbidities and prescribed medications of included patients (n = 111).

ComorbiditiesNumber (%)
Arterial hypertension86 (77.5)
Dyslipidemia63 (56.8)
Diabetes mellitus type 223 (20.7)
Heart failure12 (10.8)
Peripheral artery disease5 (4.5)
Prescribed medicationNumber (%)
Acetylsalycilic acid96 (86.5)
Beta blockers80 (72.1)
Angiotensin-convertase inhibitors64 (57.7)
Diuretics35 (31.5)
Calcium channel blockers25 (22.5)
Angiotensin-II receptor antagonists19 (17.1)
Aldosterone antagonist6 (5.4)
ComorbiditiesNumber (%)
Arterial hypertension86 (77.5)
Dyslipidemia63 (56.8)
Diabetes mellitus type 223 (20.7)
Heart failure12 (10.8)
Peripheral artery disease5 (4.5)
Prescribed medicationNumber (%)
Acetylsalycilic acid96 (86.5)
Beta blockers80 (72.1)
Angiotensin-convertase inhibitors64 (57.7)
Diuretics35 (31.5)
Calcium channel blockers25 (22.5)
Angiotensin-II receptor antagonists19 (17.1)
Aldosterone antagonist6 (5.4)
Table 2:
Open in new tab

Most common comorbidities and prescribed medications of included patients (n = 111).

ComorbiditiesNumber (%)
Arterial hypertension86 (77.5)
Dyslipidemia63 (56.8)
Diabetes mellitus type 223 (20.7)
Heart failure12 (10.8)
Peripheral artery disease5 (4.5)
Prescribed medicationNumber (%)
Acetylsalycilic acid96 (86.5)
Beta blockers80 (72.1)
Angiotensin-convertase inhibitors64 (57.7)
Diuretics35 (31.5)
Calcium channel blockers25 (22.5)
Angiotensin-II receptor antagonists19 (17.1)
Aldosterone antagonist6 (5.4)
ComorbiditiesNumber (%)
Arterial hypertension86 (77.5)
Dyslipidemia63 (56.8)
Diabetes mellitus type 223 (20.7)
Heart failure12 (10.8)
Peripheral artery disease5 (4.5)
Prescribed medicationNumber (%)
Acetylsalycilic acid96 (86.5)
Beta blockers80 (72.1)
Angiotensin-convertase inhibitors64 (57.7)
Diuretics35 (31.5)
Calcium channel blockers25 (22.5)
Angiotensin-II receptor antagonists19 (17.1)
Aldosterone antagonist6 (5.4)
PDF
This content is only available as a PDF.
© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://dbpia.nl.go.kr/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
Topic:
Issue Section:
C2 - PATHOPHYSIOLOGY, RISK FACTORS & PROGRESSION
Download all slides

Comments

0 Comments
Comments (0)
Submit a comment
You have entered an invalid code
Thank you for submitting a comment on this article. Your comment will be reviewed and published at the journal's discretion. Please check for further notifications by email.