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Volume 114, Nº 1, January 2020

   

DOI: https://doi.org/10.36660/abc.20180258

ORIGINAL ARTICLE

Left Ventricular Remodeling Patterns in Primary Healthcare

Roberto de Castro Meirelles de Almeida

Antonio José Lagoeiro Jorge

Maria Luiza Garcia Rosa

Adson Renato Leite

Dayse Mary S. Correia

Evandro Tinoco Mesquita

Sergio Chermont

Jocemir Ronaldo Lugon

Wolney de Andrade Martins



Figure 1 – A, B, and C: Evaluation of parameters of renal function in different patterns of left ventricular remodeling.





Abstract

Background: Left ventricular remodeling (LVR) is related to both non-fatal and fatal outcomes.

Objective: To describe the geometric patterns of the LV and their associations.

Methods: A total of 636 individuals between the ages of 45 and 99 years in Rio de Janeiro, Brazil, were submitted to clinical evaluation, laboratory tests, electrocardiogram, and tissue Doppler echocardiography (TDE). The difference between categories was tested with Kruskall-Wallis with post hoc tests, once all variables studied are non-normally distributed and Pearson’s Qui-square (categorical variables). Gross and adjusted ORs were estimated by logistic regression. The level of significance was 5% for all tests. Subjects had LVR characterized as: normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH).

Results: The prevalence of altered patterns was 33%. Subjects presented NG (n = 423; 67%); EH (n = 186; 29%); CH (n = 14; 2%); and CR (n = 13; 2%). The variables of gender, age, level of education and albumin/creatinine ratio (A/C), showed a relationship with the chance of EH even after adjustment.

Conclusion: Approximately one third of the studied individuals had LVR and were at risk for developing heart failure. Altered A/C in urine was associated with EH, indicating an early relationship between cardiac and renal dysfunction. (Arq Bras Cardiol. 2020; 114(1):59-65)

Keywords: Cardiovascular Diseases/physiopathology; Ventricular Remodeling; Hypertrophy, Left Ventricular; Heart failure; Renal Insufficiency; Risk Factors/complications; Comorbidity.