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Relationship between Urinary Albumin Excretion and Left Ventricular Mass with Mortality in Patients with Type 2 Diabetes

Niloofar Nobakhthaghighi^*, Mohammed Kamgar^*, Mir R. Bekheirnia^*, Kim McFann^*, Raymond Estacio, and Robert W. Schrier^*

^* Department of Medicine, Denver Health, University of Colorado Health Sciences Center, Denver, Colorado

Address correspondence to: Dr. Robert W. Schrier, University of Colorado Health Sciences Center, Division of Renal Diseases and Hypertension, 4200 East Ninth Avenue B173, Denver, CO 80262. Phone: 303-315-8059; Fax: 303-315-2685; E-mail: robert.schrier{at}uchsc.edu

Increased urinary albumin excretion (UAE) has been shown to be associated with increased cardiovascular mortality in patients with type 2 diabetes. This study evaluated whether the association between UAE and cardiovascular mortality in 880 patients with type 2 diabetes was related to an increase in left ventricular mass (LVM). LVM was estimated by electrocardiographic index, namely adjusted Cornell voltage. LVM was significantly different between the stages of albuminuria (8.17 ± 0.12 in normoalbuminuric, 9.05 ± 0.21 in microalbuminuric, and 10.30 ± 0.30 in overt albuminuric patients; P < 0.001). There also was a positive correlation between log UAE and LVM independent of BP. During 5 yr of follow-up, survivors had significantly lower LVM (8.62 ± 0.11 versus 9.88 ± 0.45; P = 0.0140) and lower UAE (154.60 ± 16.53 versus 446.62 ± 114.11; P = 0.0003) than nonsurvivors. The results indicate that patients with type 2 diabetes and increased UAE should be evaluated for increased LVM as an important and potentially reversible cardiovascular risk factor.

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