Key result
Left atrial volume index (LAVi) demonstrated a strong inverse correlation with eGFR (r = -0.92, P < .001) and provided excellent discrimination between CKD stages.
Why the study?
Chronic kidney disease drives left heart remodeling, but the utility of left heart echocardiographic parameters as rapid, non-invasive predictors of renal function decline remained to be evaluated.
Do left heart echocardiographic parameters (LAVi, E/e') correlate with estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease?
Cross-Sectional (n=100)
No
Do left heart echocardiographic parameters (LAVi, E/e') correlate with estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease?
Effect estimate: r = -0.92
p-value: p=<.001
Left atrial volume index and E/e' ratio strongly correlate with eGFR decline in CKD, suggesting utility for rapid bedside cardio-renal risk stratification.
INTRODUCTION: Chronic kidney disease (CKD) drives progressive left heart remodeling through volume overload, inflammation, and hemodynamic stress, manifesting as left atrial enlargement and diastolic dysfunction. This cross-sectional study evaluated correlations between estimated glomerular filtration rate (eGFR) and left heart echocardiographic parameters-including left atrial volume index (LAVi), E/e' ratio, and atrial filling-related parameters-in CKD stages 2-4 to assess their utility as rapid, non-invasive predictors of renal function decline, particularly in emergency settings without laboratory access. METHODS: 100 consecutive CKD patients (eGFR < 60 mL/min/1.73 m², excluding LVEF < 35%, atrial fibrillation, poor acoustic windows) underwent transthoracic echocardiography (Philips EPIQ CVx) at Modarres Hospital, Tehran (2020-2021). Confirmed left heart parameters included: LAVi (biplane area-length method, indexed to BSA); E/e' ratio (pulsed-wave mitral E-velocity ÷ septal tissue Doppler e'-velocity); atrial filling parameters per ASE guidelines. eGFR calculated via CKD-EPI. Statistical analysis comprised Pearson/Spearman correlations, t-tests/Mann-Whitney U, and ROC curves (SPSS v22, P < .05). RESULTS: Mean age 61.1 ± 12.7 years (65 males); eGFR 60.76 ± 14.15 mL/min/1.73 m². Strong inverse correlation: eGFR vs LAVi (r = -0.92, P < .001). Moderate inverse correlations: eGFR vs E/e' (r = -0.54, P < .0001). Atrial filling parameters progressively impaired with CKD advancement. LAVi demonstrated excellent discriminatory performance: AUC 0.98 (95% CI 0.97-1.00) for stage 2 vs 3-4; AUC 0.92 (95% CI 0.86-0.97) for stage 3. Optimal cutoffs: ≥ 30 mL/m² (sens 100%, spec 91.4%); ≥ 41 mL/m² (sens 100%, spec 97.9%). Performance robust across LVEF subgroups. CONCLUSION: LAVi, E/e', and atrial filling parameters exhibit strong, progressive correlations with eGFR decline in CKD, offering excellent bedside discrimination of disease stages independent of laboratory measures. These left heart indices support rapid cardio-renal risk stratification; multicenter longitudinal validation warranted.
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Bagheri et al. (2026) conducted a cross-sectional in Chronic Kidney Disease (n=100). Left heart echocardiographic parameters (LAVi, E/e') was evaluated on Correlation between estimated glomerular filtration rate (eGFR) and left atrial volume index (LAVi) (r = -0.92, p=<.001). Left atrial volume index (LAVi) demonstrated a strong inverse correlation with eGFR (r = -0.92, P < .001) and provided excellent discrimination between CKD stages.
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