Renal Function and Cardiac Structure and Function Following MI: The VALIANT Echo Study

Abstract

Introduction: It is unknown if adverse cardiovascular outcomes in post-MI pts with reduced renal function can be attributed to abnormalities of cardiac structure or function. Methods: Quantitative echocardiographic (echo) analyses were performed at baseline in 603 pts with LV dysfunction, HF, or both after MI, from VALIANT. Estimated glomerular filtration rate (eGFR) was calculated using the MDRD equation, and divided into 4 groups (<45.0, 45.0–59.9, 60.0–74.9, ≥75.0). Echo characteristics were related to baseline eGFR. Results: Reduced eGFR was associated with increased death or HF hospitalization, and smaller LV end-diastolic volumes, higher wall motion score, larger LA volumes, and more MR. Neither EF, infarct segment length, RV function, nor mitral deceleration time varied by renal function. After adjusting for age, wall motion index, LA volume, and MR remained significantly associated with reduced eGFR. Conclusions: Pts with renal impairment have similar global RV and LV systolic function, infarct segment length, smaller ventricular volumes, and larger atrial volumes after MI. Reduced systolic function alone cannot account for worse outcomes in post-MI pts with renal impairment.