Table 2.
Association of Left Atrial Function Measures with Incident CKD: The Atherosclerosis Risk in Communities Study, 2011-2019 (n=4002)a
| LA reservoir strain (%) |
||||||
|---|---|---|---|---|---|---|
| ≤25.82 (n=801) | 25.83-30.11 (n=800) | 30.12-34.15 (n=801) | 34.16-39.25 (n=799) | ≥39.26 (n=801) | Per 1-SD decrease (8.6) | |
| N, incident CKD | 200 | 125 | 107 | 89 | 77 | 598 |
| IR per 100 PY | 4.57 | 2.42 | 1.99 | 1.62 | 1.37 | 2.29 |
| HR (95% CI) | ||||||
| Model 1 | 3.50 (2.67-4.59) | 1.75 (1.31-2.33) | 1.42 (1.06-1.91) | 1.23 (0.90-1.67) | Reference | 1.59 (1.47-1.73) |
| Model 2 | 2.65 (1.99-3.54) | 1.44 (1.08-1.92) | 1.29 (0.96-1.73) | 1.07 (0.79-1.46) | Reference | 1.49 (1.35-1.64) |
| Model 3 | 1.94 (1.42-2.64) | 1.31 (0.98-1.75) | 1.22 (0.91-1.64) | 1.03 (0.76-1.40) | Reference | 1.29 (1.16-1.44) |
| LA conduit strain (%) |
||||||
|---|---|---|---|---|---|---|
| ≤9.88 (n=800) | 9.89-12.90 (n=799) | 12.91-15.86 (n=805) | 15.87-19.46 (n=798) | ≥19.47 (n=800) | Per 1-SD decrease (5.7) | |
| N, incident CKD | 174 | 135 | 113 | 105 | 71 | 598 |
| IR per 100 PY | 3.73 | 2.68 | 2.10 | 1.95 | 1.27 | 2.29 |
| HR (95% CI) | ||||||
| Model 1 | 2.94 (2.21-3.91) | 1.99 (1.49-2.67) | 1.62 (1.20-2.19) | 1.54 (1.14-2.08) | Reference | 1.44 (1.32-1.59) |
| Model 2 | 2.07 (1.54-2.77) | 1.54 (1.15-2.07) | 1.30 (0.96-1.75) | 1.34 (0.99-1.82) | Reference | 1.28 (1.16-1.41) |
| Model 3 | 1.62 (1.19-2.20) | 1.38 (1.03-1.86) | 1.25 (0.92-1.69) | 1.32 (0.97-1.78) | Reference | 1.15 (1.04-1.27) |
| LA contractile strain (%) |
||||||
|---|---|---|---|---|---|---|
| ≤12.72 (n=800) | 12.73-16.04 (n=803) | 16.05-18.83 (n=799) | 18.84-22.23 (n=800) | ≥22.24 (n=800) | Per 1-SD decrease (6.3) | |
| N, incident CKD | 168 | 124 | 114 | 104 | 99 | 598 |
| IR per 100 PY | 3.58 | 2.38 | 2.19 | 1.91 | 1.60 | 2.29 |
| HR (95% CI) | ||||||
| Model 1 | 2.27 (1.75-2.94) | 1.55 (1.18-2.04) | 1.45 (1.10-1.92) | 1.23 (0.93-1.64) | Reference | 1.35 (1.25-1.46) |
| Model 2 | 1.92 (1.47-2.52) | 1.52 (1.15-2.01) | 1.46 (1.11-1.94) | 1.25 (0.94-1.66) | Reference | 1.29 (1.18-1.41) |
| Model 3 | 1.49 (1.12-1.99) | 1.36 (1.03-1.79) | 1.34 (1.02-1.78) | 1.19 (0.90-1.59) | Reference | 1.17 (1.06-1.28) |
Model 1: adjusted for age, sex, race/center, education, and baseline eGFR. Model 2: adjusted for model 1 plus body mass index, smoking status, HbA1c, systolic blood pressure, diabetes, stroke, coronary heart disease, heart failure, atrial fibrillation, peripheral artery disease, and antihypertensive medication use. Model 3: adjusted for model 2 plus LV ejection fraction, E/e' average ratio, LV mass index, and LA volume index.
Abbreviations: CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; HbA1c, hemoglobin A1c; HR, hazard ratio; IR, incidence rate; LA, left atrial; LV, left ventricular; PY, person-year, SD, standard deviation.