SHAN Xiaoli, CHI Runze, YU Xin, LI Bingong. Correlation between left atrial diameter and renal function in patients with atrial fibrillation[J]. Journal of Clinical Medicine in Practice, 2024, 28(9): 34-39. DOI: 10.7619/jcmp.20240497
Citation: SHAN Xiaoli, CHI Runze, YU Xin, LI Bingong. Correlation between left atrial diameter and renal function in patients with atrial fibrillation[J]. Journal of Clinical Medicine in Practice, 2024, 28(9): 34-39. DOI: 10.7619/jcmp.20240497

Correlation between left atrial diameter and renal function in patients with atrial fibrillation

More Information
  • Received Date: January 25, 2024
  • Revised Date: March 28, 2024
  • Available Online: May 14, 2024
  • Objective 

    To explore the correlation between left atrial diameter (LAD) and renal function in patients with atrial fibrillation.

    Methods 

    A total of 364 patients with atrial fibrillation were selected as study subjects. Clinical data of the patients were collected, including gender, age, height, body weight, smoking history, drinking history, atrial fibrillation type, history of hypertension, coronary heart disease, diabetes, heart failure, medication history, high-sensitivity troponin I, brain natriuretic peptide, C-reactive protein, creatinine, urea nitrogen, LAD, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVDd), left ventricular posterior wall thickness (LVPWTd), and interventricular septal thickness (IVSTd). Estimated glomerular filtration rate (eGFR) and body mass index were calculated. Spearman correlation analysis was used to explore the correlations of LAD with creatinine, urea nitrogen, and eGFR. With eGFR < 60 mL/(min·1.73 m2) setting as renal insufficiency, univariate Logistic regression analysis was used to explore the influencing factors of renal insufficiency in patients with atrial fibrillation. Binary Logistic regression analysis was used to explore the relationship between LAD and renal insufficiency in patients with atrial fibrillation.

    Results 

    Spearman correlation analysis showed that LAD was positively correlated with creatinine (r=0.279, P < 0.001) and urea nitrogen (r=0.190, P < 0.001) in patients with atrial fibrillation, and negatively correlated with eGFR (r=-0.263, P < 0.001). Univariate Logistic regression analysis showed that gender, history of diabetes, hypertension, coronary heart disease, heart failure, atrial fibrillation type, sodium-glucose cotransporter 2 inhibitor medication history, diuretic medication history, LAD, LVEF, LVDd, and IVSTd were all influencing factors of renal insufficiency in patients with atrial fibrillation (P < 0.05). Binary Logistic regression analysis showed that compared with the first quartile of LAD (LAD ≤ 38 mm), the risk of renal insufficiency in patients with atrial fibrillation in the fourth quartile of LAD (LAD>47 mm) increased by 5.199 times(OR=5.199; 95 %CI, 1.210 to 22.337; P=0.027).

    Conclusion 

    LAD of patients with atrial fibrillation is significantly related to renal function, and LAD is an influencing factor of renal insufficiency in patients with atrial fibrillation.

  • [1]
    BAMAN J R, PASSMAN R S. Atrial fibrillation[J]. JAMA, 2021, 325(21): 2218. doi: 10.1001/jama.2020.23700
    [2]
    LIPPI G, SANCHIS-GOMAR F, CERVELLIN G. Global epidemiology of atrial fibrillation: an increasing epidemic and public health challenge[J]. Int J Stroke, 2021, 16(2): 217-221. doi: 10.1177/1747493019897870
    [3]
    WIJESURENDRA R S, CASADEI B. Mechanisms of atrial fibrillation[J]. Heart, 2019, 105(24): 1860-1867. doi: 10.1136/heartjnl-2018-314267
    [4]
    中华医学会心电生理和起搏分会, 中国医师协会心律学专业委员会, 中国房颤中心联盟心房颤动防治专家工作委员会. 心房颤动: 目前的认识和治疗建议(2021)[J]. 中华心律失常学杂志, 2022, 26(1): 15-88.
    [5]
    KASHANI K, ROSNER M H, OSTERMANN M. Creatinine: from physiology to clinical application[J]. Eur J Intern Med, 2020, 72: 9-14. doi: 10.1016/j.ejim.2019.10.025
    [6]
    WANG Y N, YANG Y, HE F. Insights into concomitant atrial fibrillation and chronic kidney disease[J]. Rev Cardiovasc Med, 2022, 23(3): 105. doi: 10.31083/j.rcm2303105
    [7]
    PATEL R B, FONAROW G C, GREENE S J, et al. Kidney function and outcomes in patients hospitalized with heart failure[J]. J Am Coll Cardiol, 2021, 78(4): 330-343. doi: 10.1016/j.jacc.2021.05.002
    [8]
    BARASHI R, HORNIK-LURIE T, GABAY H, et al. Renal function and outcome of patients with non-valvular atrial fibrillation[J]. Eur Heart J Acute Cardiovasc Care, 2021, 10(10): 1180-1186. doi: 10.1093/ehjacc/zuab075
    [9]
    米琴, 郭雪娅. 心房颤动与慢性肾脏病相关性研究[J]. 中华老年心脑血管病杂志, 2019, 21(2): 204-206. doi: 10.3969/j.issn.1009-0126.2019.02.025
    [10]
    RIMMELE D L, BOROF K, JENSEN M, et al. Association between carotid atherosclerosis and atrial fibrillation, cardiac, and renal function[J]. Eur J Vasc Endovasc Surg, 2022, 63(4): 641-647. doi: 10.1016/j.ejvs.2022.01.010
    [11]
    HU Y F, CHEN Y J, LIN Y J, et al. Inflammation and the pathogenesis of atrial fibrillation[J]. Nat Rev Cardiol, 2015, 12(4): 230-243. doi: 10.1038/nrcardio.2015.2
    [12]
    TAPOI L, URECHE C, SASCAU R, et al. Atrial fibrillation and chronic kidney disease conundrum: an update[J]. J Nephrol, 2019, 32(6): 909-917. doi: 10.1007/s40620-019-00630-1
    [13]
    KOZBERG M G, PEROSA V, GUROL M E, et al. A practical approach to the management of cerebral amyloid angiopathy[J]. Int J Stroke, 2021, 16(4): 356-369. doi: 10.1177/1747493020974464
    [14]
    FLORIA M, TANASE D M. Atrial fibrillation type and renal dysfunction: new challenges in thromboembolic risk assessment[J]. Heart, 2019, 105(17): 1295-1297. doi: 10.1136/heartjnl-2019-315212
    [15]
    PARK S, LEE S, KIM Y, et al. Atrial fibrillation and kidney function: a bidirectional Mendelian randomization study[J]. Eur Heart J, 2021, 42(29): 2816-2823. doi: 10.1093/eurheartj/ehab291
    [16]
    VAN DER BURGH A C, GEURTS S, IKRAM M A, et al. Bidirectional association between kidney function and atrial fibrillation: a population-based cohort study[J]. J Am Heart Assoc, 2022, 11(10): e025303. doi: 10.1161/JAHA.122.025303
    [17]
    GENG T T, WANG Y, LU Q, et al. Associations of new-onset atrial fibrillation with risks of cardiovascular disease, chronic kidney disease, and mortality among patients with type 2 diabetes[J]. Diabetes Care, 2022, 45(10): 2422-2429. doi: 10.2337/dc22-0717
    [18]
    张爱丽, 侯旗旗, 韩全乐, 等. 中国北方人群心房颤动与新发慢性肾脏病发病风险的相关性研究[J]. 中国全科医学, 2023, 26(36): 4521-4526. doi: 10.12114/j.issn.1007-9572.2023.0006
    [19]
    DING W Y, GUPTA D, WONG C F, et al. Pathophysiology of atrial fibrillation and chronic kidney disease[J]. Cardiovasc Res, 2021, 117(4): 1046-1059. doi: 10.1093/cvr/cvaa258
    [20]
    LÓPEZ-GALVEZ R, RIVERA-CARAVACA J M, ROLDÁN V, et al. Imaging in atrial fibrillation: a way to assess atrial fibrosis and remodeling to assist decision-making[J]. Am Heart J, 2023, 258: 1-16. doi: 10.1016/j.ahj.2022.12.007
    [21]
    THOMAS L, ABHAYARATNA W P. Left atrial reverse remodeling: mechanisms, evaluation, and clinical significance[J]. JACC Cardiovasc Imaging, 2017, 10(1): 65-77. doi: 10.1016/j.jcmg.2016.11.003
    [22]
    MILLS H, ESPERSEN K, JURLANDER R, et al. Prevention of sudden cardiac death in hypertrophic cardiomyopathy: risk assessment using left atrial diameter predicted from left atrial volume[J]. Clin Cardiol, 2020, 43(6): 581-586. doi: 10.1002/clc.23351
    [23]
    THOMAS L, MURARU D, POPESCU B A, et al. Evaluation of left atrial size and function: relevance for clinical practice[J]. J Am Soc Echocardiogr, 2020, 33(8): 934-952. doi: 10.1016/j.echo.2020.03.021
    [24]
    BEYER C, TOKARSKA L, STÜHLINGER M, et al. Structural cardiac remodeling in atrial fibrillation[J]. JACC Cardiovasc Imaging, 2021, 14(11): 2199-2208. doi: 10.1016/j.jcmg.2021.04.027
    [25]
    GOETTE A, LENDECKEL U. Atrial cardiomyopathy: pathophysiology and clinical consequences[J]. Cells, 2021, 10(10): 2605. doi: 10.3390/cells10102605
    [26]
    NGUYEN H T T, DO C V, DANG D T V, et al. Progressive alterations of left atrial and ventricular volume and strain across chronic kidney disease stages: a speckle tracking echocardiography study[J]. Front Cardiovasc Med, 2023, 10: 1197427. doi: 10.3389/fcvm.2023.1197427
    [27]
    CHEN S C, CHANG J M, TSAI Y C, et al. Left atrial diameter and albumin with renal outcomes in chronic kidney disease[J]. Int J Med Sci, 2013, 10(5): 575-584. doi: 10.7150/ijms.5845
    [28]
    HUANG T H, CHIU H, WU P Y, et al. The association of echocardiographic parameters on renal outcomes in chronic kidney disease[J]. Ren Fail, 2021, 43(1): 433-444. doi: 10.1080/0886022X.2021.1885444
    [29]
    HU L L, XIONG Q M, CHEN Z Q, et al. Factors associated with a large decline in renal function or progression to renal insufficiency in hospitalized atrial fibrillation patients with early-stage CKD[J]. Int Heart J, 2020, 61(2): 239-248. doi: 10.1536/ihj.19-205
  • Related Articles

    [1]QU Liying, ZHANG Wei, HU Jieqiong, QU Xiaoling, LIU Yan. Effect of cluster nursing for elderly patients with swallowing dysfunction[J]. Journal of Clinical Medicine in Practice, 2024, 28(23): 136-139. DOI: 10.7619/jcmp.20242667
    [2]MIAO Wenjie, WANG Huimin, ZHOU Hang, LU Baocai, LIAN Rong. Effect of laryngeal function reconstruction of sternohyoid muscle inversion for treatment of glottic carcinoma[J]. Journal of Clinical Medicine in Practice, 2024, 28(17): 41-44, 50. DOI: 10.7619/jcmp.20242602
    [3]ZHANG Hao, LIANG Dongxing, LIU Tao, TIAN Yuan, SHI Xiaolin, YANG Yongming. Effect of modified percutaneous minimally invasive repair surgery in treatment of patients with acute closed rupture of Achilles's tendon[J]. Journal of Clinical Medicine in Practice, 2021, 25(20): 102-105. DOI: 10.7619/jcmp.20212251
    [4]CUI Yuan, ZHANG Qingyan, ZHANG Mingzhuo, JIANG Chunming, LIU Ying, XU Pengfei, ZHANG Miao. Analysis in influencing factors of long-term prognosis in patients with maintenance peritoneal dialysis[J]. Journal of Clinical Medicine in Practice, 2021, 25(14): 57-61. DOI: 10.7619/jcmp.20210733
    [5]HONG Yuangeng, YAO Liping, YE Xiaowu. Effect of laser endoscopic surgery and laryngectomy on respiratory as well as swallowing functions in patients with laryngeal carcinoma[J]. Journal of Clinical Medicine in Practice, 2021, 25(4): 26-28, 33. DOI: 10.7619/jcmp.20201939
    [6]LI Guihua, WANG Yan, ZHAI Nan. Effect of comprehensive nursing intervention combined with biofeedback therapy in elderly patients with functional constipation[J]. Journal of Clinical Medicine in Practice, 2018, (4): 72-75. DOI: 10.7619/jcmp.201804021
    [7]LIU Guoju, DING Yun, CHENG Yuefeng, LIANG Caihong. Effect of drinking water test combined with swallowing training for the treatment of cerebral infarction patients with dysphagia[J]. Journal of Clinical Medicine in Practice, 2018, (2): 5-8. DOI: 10.7619/jcmp.201802002
    [8]HE Xiwu, TIAN Fengxuan, ZHANG Qiang. Clinical effect of swallowing function training on reducing lung infection in craniocerebral injury patients with tracheotomy[J]. Journal of Clinical Medicine in Practice, 2017, (15): 25-28. DOI: 10.7619/jcmp.201715007
    [9]ZHU Lingyun, TANG Liping, SHU Lingling. The effect of early nursing intervention on the diet of swallowing dysfunction patients after acoustic neuroma surgery[J]. Journal of Clinical Medicine in Practice, 2015, (2): 44-46. DOI: 10.7619/jcmp.201502014
    [10]QIAN Keyan. Bedside swallowing function screening and rehabilitation nursing in the application of Parkinson's disease[J]. Journal of Clinical Medicine in Practice, 2015, (2): 14-16. DOI: 10.7619/jcmp.201502005

Catalog

    Article views PDF downloads Cited by()

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return