{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:09:35Z","timestamp":1788412175934,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Several studies revealed a relation between abnormal cardiac remodeling and glomerular filtration rate (GFR) decline, but there are limited data regarding echocardiographic changes in chronic kidney disease (CKD). This study evaluated the abnormal cardiac structures characterizing patients with CKD, assessing the independent association between echocardiographic parameters and the risk of decline in renal function. Materials and Methods: In total, 160 patients with CKD were studied. All patients underwent an echocardiographic exam and 99mTc-DTPA renal scintigraphy to measure the GFR. After the baseline assessments, patients were followed prospectively for 12 months, or until the endpoint achievement, defined as a worsening in renal function (doubling of baseline serum creatinine, GFR decline \u226525%, the start of dialysis). Results: Patients with GFR values of 34.8 \u00b1 15 mL\/min, identifying stages III\u2013IV of CKD, were associated with high levels of left ventricular mass index (LVMi) (101.9 \u00b1 12.2 g\/m2), which was related to proteinuria, systolic blood pressure, and pulmonary artery systolic pressure in a multiple regression model. During the observational period, 26% of patients reached the endpoint. Regression analysis revealed LVMi as a predictor of change in renal function after adjusting for kidney and cardiac risk factors. Multiple Cox regression indicated that an increase in LVMi was associated with a 12% increased risk of kidney disease progression (HR: 1.12; 95% CI: 1.04\u20131.16; p = 0.001). Conclusions: In patients with CKD, high LVMi represents an independent predictor of the progressive decline of the renal function, until the start of renal replacement therapy. Echocardiography can help identify patients at high risk for renal disease worsening in patients with CKD independently of clinical cardiac involvement.<\/jats:p>","DOI":"10.3390\/medicina60010127","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T05:47:21Z","timestamp":1704865641000},"page":"127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney Disease"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1705-8770","authenticated-orcid":false,"given":"Antonio","family":"Lacquaniti","sequence":"first","affiliation":[{"name":"Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1286-0505","authenticated-orcid":false,"given":"Fabrizio","family":"Ceresa","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Campo","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5023-6247","authenticated-orcid":false,"given":"Francesco","family":"Patan\u00e9","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0492-5022","authenticated-orcid":false,"given":"Paolo","family":"Monardo","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1161\/CIRCULATIONAHA.120.050686","article-title":"Cardiovascular Disease in Chronic Kidney Disease: Pathophysiological Insights and Therapeutic Options","volume":"143","author":"Jankowski","year":"2021","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Pliquett, R.U. (2022). Cardiorenal Syndrome: An Updated Classification Based on Clinical Hallmarks. J. Clin. Med., 11.","DOI":"10.3390\/jcm11102896"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.jjcc.2009.05.002","article-title":"Left ventricular diastolic dysfunction in the early stage of chronic kidney disease","volume":"54","author":"Otsuka","year":"2009","journal-title":"J. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1136\/heartjnl-2022-321404","article-title":"Echocardiographic features of left ventricular dysfunction and outcomes in chronic kidney disease","volume":"109","author":"Ou","year":"2022","journal-title":"Heart"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1053\/j.ajkd.2023.01.442","article-title":"Cardiac Structure and Function and Subsequent Kidney Disease Progression in Adults with CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study","volume":"82","author":"Ishigami","year":"2023","journal-title":"Am. J. Kidney Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"8863","DOI":"10.1038\/s41598-023-35440-w","article-title":"The association between changes in echocardiography and risk of heart failure hospitalizations and death in adults with chronic kidney disease","volume":"13","author":"Fitzpatrick","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.cardiores.2005.10.001","article-title":"The role of natriuretic peptides in cardioprotection","volume":"69","author":"Nishikimi","year":"2006","journal-title":"Cardiovasc. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1681\/ASN.2011100985","article-title":"Natriuretic peptide receptor guanylyl cyclase-A protects podocytes from aldosterone-induced glomerular injury","volume":"23","author":"Ogawa","year":"2012","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1161\/HYPERTENSIONAHA.115.05610","article-title":"B-Type Natriuretic Peptide Deletion Leads to Progressive Hypertension, Associated Organ Damage, and Reduced Survival: Novel Model for Human Hypertension","volume":"66","author":"Holditch","year":"2015","journal-title":"Hypertension"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3442","DOI":"10.1093\/eurheartj\/ehu254","article-title":"Association between renal function and cardiovascular structure and function in heart failure with preserved ejection fraction","volume":"35","author":"Gori","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1681\/ASN.2012020145","article-title":"Chronic Renal Insufficiency Cohort (CRIC) Study Group. Associations between kidney function and subclinical cardiac abnormalities in CKD","volume":"23","author":"Park","year":"2012","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Mavrakanas, T.A., Khattak, A., Singh, K., and Charytan, D. (2018). Echocardiographic parameters and renal outcomes in patients with preserved renal function, and mild- moderate CKD. BMC Nephrol., 19.","DOI":"10.1186\/s12882-018-0975-5"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1161\/HYPERTENSIONAHA.111.00904","article-title":"Relationship of left ventricular hypertrophy and diastolic function with cardiovascular and renal outcomes in African Americans with hypertensive chronic kidney disease","volume":"62","author":"Peterson","year":"2013","journal-title":"Hypertension"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1053\/j.ajkd.2016.11.022","article-title":"Echocardiographic Measures and Estimated GFR Decline Among African Americans: The Jackson Heart Study","volume":"70","author":"Zelnick","year":"2017","journal-title":"Am. J. Kidney Dis."},{"key":"ref_15","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group (2013). KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. Suppl., 3, 1\u2013150."},{"key":"ref_16","first-page":"1086","article-title":"American Society of Echocardiography recommendations for use of echocardiography in clinical trials","volume":"17","author":"Gottdiener","year":"2004","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/0002-9149(76)90491-4","article-title":"Problems in echocardiographic volume determinations: Echocardiographic-angiographic correlations in the presence of absence of asynergy","volume":"37","author":"Teichholz","year":"1976","journal-title":"Am. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S0735-1097(85)80172-8","article-title":"Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound","volume":"6","author":"Berger","year":"1985","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/S0894-7317(14)80415-X","article-title":"Septal\/free wall curvature ratio: A noninvasive index of pulmonary arterial pressure","volume":"7","author":"Reisner","year":"1994","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1093\/ndt\/13.2.244","article-title":"Doubling of serum creatinine: Is it sensitive and relevant?","volume":"13","author":"Rossing","year":"1998","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1056\/NEJMoa1114248","article-title":"Estimating glomerular filtration rate from serum creatinine and cystatin C","volume":"367","author":"Inker","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1093\/ndt\/16.suppl_7.57","article-title":"Identification of patients and risk factors in chronic kidney disease evaluating risk factors and therapeutic strategies","volume":"16","author":"Levin","year":"2001","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1161\/01.CIR.0000025242.79963.4C","article-title":"B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: Analysis from Breathing Not Properly (BNP) Multinational Study","volume":"106","author":"McCullough","year":"2002","journal-title":"Circulation"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.2215\/CJN.03350509","article-title":"Determinants of left ventricular mass and hypertrophy in hemodialysis patients assessed by cardiac magnetic resonance imaging","volume":"4","author":"Patel","year":"2009","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1159\/000529526","article-title":"Defining Biventricular Abnormalities by Cardiac Magnetic Resonance in Pre-Dialysis Patients with Chronic Kidney Disease","volume":"9","author":"Qi","year":"2023","journal-title":"Kidney Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s11255-023-03624-y","article-title":"Combinative predictive effect of left ventricular mass index, ratio of HDL and CRP for progression of chronic kidney disease in non-dialysis patient","volume":"56","author":"Tang","year":"2023","journal-title":"Int. Urol. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"S\u00e1gi, B., K\u00e9s\u0151i, I., Vas, T., Csiky, B., Nagy, J., and Kov\u00e1cs, T.J. (2022). Left ventricular myocardial mass index associated with cardiovascular and renal prognosis in IgA nephropathy. BMC Nephrol., 23.","DOI":"10.1186\/s12882-022-02909-1"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1053\/j.ajkd.2005.06.017","article-title":"B-type natriuretic peptide (BNP) and amino-terminal proBNP in patients with CKD: Relationship to renal function and left ventricular hypertrophy","volume":"46","author":"Vickery","year":"2005","journal-title":"Am. J. Kidney Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.2215\/CJN.00850208","article-title":"Natriuretic peptides in chronic kidney disease","volume":"3","author":"Tagore","year":"2008","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"14612","DOI":"10.1074\/jbc.273.23.14612","article-title":"Autocrine\/paracrine determinants of strain activated brain natriuretic peptide gene expression in cultured cardiac myocytes","volume":"273","author":"Liang","year":"1998","journal-title":"J. Biol. Chem."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s40620-016-0276-7","article-title":"Kidney-lung connections in acute and chronic diseases: Current perspectives","volume":"29","author":"Visconti","year":"2016","journal-title":"J. Nephrol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Yang, S.F., Chou, R.H., Lin, S.J., Li, S.Y., and Huang, P.H. (2019). Serum PCSK6 and corin levels are not associated with cardiovascular outcomes in patients undergoing coronary angiography. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0226129"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1053\/j.jrn.2008.10.024","article-title":"Salivary phosphorus and phosphate content of beverages: Implications for the treatment of uremic hyperphosphatemia","volume":"19","author":"Savica","year":"2009","journal-title":"J. Ren. Nutr."},{"key":"ref_34","first-page":"8","article-title":"Lipid disorders in patients with renal failure: Role in cardiovascular events and progression of chronic kidney disease","volume":"6","author":"Visconti","year":"2016","journal-title":"J. Clin. Transl. Endocrinol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s10238-014-0272-y","article-title":"Apelin beyond kidney failure and hyponatremia: A useful biomarker for cancer disease progression evaluation","volume":"15","author":"Lacquaniti","year":"2015","journal-title":"Clin. Exp. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ahj.2023.03.003","article-title":"Effect of active vitamin-D on left ventricular mass index: Results of a randomized controlled trial in type 2 diabetes and chronic kidney disease","volume":"261","author":"Gnudi","year":"2023","journal-title":"Am. Heart J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1056\/NEJMoa2022190","article-title":"Cardiovascular and renal outcomes with empagliflozin in heart failure","volume":"383","author":"Packer","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1056\/NEJMoa2107038","article-title":"Empagliflozin in heart failure with a preserved ejection fraction","volume":"385","author":"Anker","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1002\/ehf2.14357","article-title":"Impact of diabetes duration on left ventricular mass regression with empagliflozin","volume":"10","author":"Moroney","year":"2023","journal-title":"ESC Heart Fail."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.bbrc.2020.01.015","article-title":"The SGLT2 inhibitor empagliflozin reduces mortality and prevents progression in experimental pulmonary hypertension","volume":"524","author":"Chowdhury","year":"2020","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1161\/CIRCULATIONAHA.120.052503","article-title":"Empagliflozin effects on pulmonary artery pressure in patients with heart failure: Results from EMpagliflozin Evaluation by MeasuRing ImpAct on HemodynamiCs in PatiEnts with Heart Failure (EMBRACE-HF) Trial","volume":"143","author":"Nassif","year":"2021","journal-title":"Circulation"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/1\/127\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:43:38Z","timestamp":1760103818000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/1\/127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,10]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["medicina60010127"],"URL":"https:\/\/doi.org\/10.3390\/medicina60010127","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,10]]}}}