JAMA Cardiol; 2019 Nov 17; EPub Ahead of Print; RB Patel, LA Colangelo, JP Reis, et al
The prospective CARDIA study followed a cohort of 2647 young adults (aged 18–30 years at baseline) for 30 years to determine the trajectory of albuminuria and its relationship with echocardiographic indices. To measure albuminuria, single urine albumin-to-creatinine ratio (UACR) levels were used. UACR trajectories from year 10 to year 30 were divided into five groups: low-stable (64.9%), moderate-stable (25.8%), high-stable (4.4%), moderate-increasing (3.3%), and high-increasing (1.6%). The median baseline UACR levels were below 30 mg/g in all groups except for the high-increasing group. In an adjusted analysis, left ventricular (LV) mass, LV longitudinal strain, estimated LV filling pressures, and e’ tissue velocities differed significantly by trajectory group. This study identified distinct UACR trajectories over a 20-year period, and these trajectories were associated in differences with myocardial structure and function. Identifying these trajectories may be helpful in clinical risk stratification.