Association of Serum Lipoprotein(a) with Left Ventricular Hypertrophy and Left Ventricular ejection Fraction in End-Stage Renal Failure Patients Under Hemodialysis

Abstract

Background: The contribution of cardiovascular events to the extraordinary high mortality in end-stage-renal disease (ESRD) has generated some interest in non traditional athero sclerotic cardiovascular diseaserisk factors that are prevalent in ESRD , such as Lipoprotein(a) [Lp(a)]. In this study we aimed to consider the association of serum lipoproein(a)) with left ventricular hypertrophy (LVH) and hypertention (HTN) in ESRD patients under regular hemodialysis . Methods and patients: 61 unselected patients with end-stage renal disease (ESRD), undergoing maintenance hemodialysis treatment were studied. Lipoprotein (a) was measured by enzyme immuno assay (ELISA) test, all patients were echographied for left ventricular hypertrophy and left ventricular (LV) ejection fraction (EF). Hypertensive patients were stratified into no HTN, stage one to three HTN, as well as LVH was stratified to normal, mild, moderate and severe. Results: The total number of patients was 61(F=23 M=38). They consisted of 50 non diabetic hemodialysis patients (F=20 M=30) and 11 diabetic hemodialysis patients (F=3 M=8). Mean±SD of LP(a) of all patients was 58.5±19mg/dl. Mean±SD of LP(a) of the diabetic group was 62±12.3 mg/dl and for the nondiabetic group it was 57.7±20 mg/dl. There was a significant positive relationship between stages of LVH and stages of HTN, significant positive correlation between presence of chest pain and stages of LVH, significant reverse correlation of Lp(a) with percent of LV ejection fraction, as well as positive correlation of serum LP(a) with stages of HTN. A significant correlation between stages of LVH with serum LP(a) was observed this study. Conclusions: Lipoprotein(a) has an adverse effect on left ventricular hyperthrophy and hypertention of hemodialysis patients and needs more attention.