Clinical InvestigationCongestive Heart FailureVitamin D reduces left atrial volume in patients with left ventricular hypertrophy and chronic kidney disease
Section snippets
Study population
The PRIMO study enrolled 227 patients from 60 centers in 11 countries between July 2008 and September 2010. Details of the protocol and primary results have been reported previously.26 In brief, patients were 18 to 75 years old with LV hypertrophy on 2-dimensional transthoracic echocardiography (septal wall thickness of 1.1-1.7 cm in females, 1.2-1.8 cm in males),27 LV ejection fraction (LVEF) >50%, and estimated glomerular filtration rate (eGFR) of 15 to 60 mL/minute per 1.73m2. Patients on
Baseline characteristics
A total of 196 (86%) of the 227 enrolled patients in the PRIMO study had available longitudinal echocardiographic data; 103 were randomly assigned to paricalcitol; and 93, to placebo. Baseline characteristics were similar between groups (Table I). Participants were mostly white males with hypertension. Other cardiovascular risk factors, such as obesity and diabetes mellitus, were highly prevalent in both groups. Most participants were receiving RAAS inhibitors (79% in paricalcitol vs 80% in
Discussion
The nephrology community has long sought interventions to modify cardiac structure and function given the marked elevation in risk for cardiovascular disease and the almost universal findings of altered cardiac structure and function in this population. In this post hoc analysis of the PRIMO trial, we demonstrate that paricalcitol therapy over 48 weeks was associated with a significant decrease in LAVi in patients with CKD, despite similar blood pressure control and superimposed RAAS inhibitor
Disclosures
Dr. Thadhani received a coordinating grant from Abbot Laboratories to the Massachusetts General Hospital, speaker's fees and travel support from Abbot Laboratories. Drs. Pritchett, Andress, and Zhang are employees of Abbott Laboratories and may own Abbott stock or options. Drs. Agarwal, Zoccali, Wanner and Zehnder received honoraria from Abbott Laboratories for lectures or for participation in steering committee. Dr. Manning received travel support for a CMR meeting from Abbott Laboratories.
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