Abstract
BackgroundTo investigate the prevalence of left ventricular hypertrophy (LVH) and explore left ventricular geometry in maintenance hemodialysis (MHD) patients, and to explore the risk factors of LVH which is an important predictor of cardiovascular events.MethodsThe subjects were patients who are on MHD for more than 3 months in Peking University People's Hospital from March 2015 to February 2017. Demographic and clinical data were retrospectively collected. Left ventricular mass was measured by echocardiography. LVH is defined by Left ventricular mass index (LVMI) > 115 g/m2 for men and > 95 g/m2 in women. LVMI and relative wall thickness were used to determine left ventricular geometry. Logistic regression was used to analyze the risk factors of LVH.ResultsAltogether, 131 patients including 77 males were enrolled. The median age was 60 (47, 69) years, with a median dialysis vintage of 48 (18, 104) months. There were 80 patients with LVH, the prevalence rate was 61.1%, and 66.3% of them were moderate to severe LVH. We found that (1) most of the patients were concentric hypertrophy; (2) one-third of the patients were concentric remodeling; (3) only 4 cases with normal geometry. The pre-dialysis serum sodium level and time average pre-dialysis systolic blood pressure (SBP) were independent risk factors of LVH.ConclusionLVH is prevalent in MHD patients. Concentric hypertrophy and concentric remodeling are the most common geometric patterns. Attention should be paid to long-term pre-dialysis SBP management and pre-dialysis sodium control as they might be potentially modifiable risk factors for LVH.
Highlights
To investigate the prevalence of left ventricular hypertrophy (LVH) and explore left ventricular geometry in maintenance hemodialysis (MHD) patients, and to explore the risk factors of LVH which is an important predictor of cardiovascular events
In non-dialysis dependent chronic kidney disease (CKD) patients, the prevalence of LVH is around 47%; while in end stage kidney disease (ESKD) patients, the prevalence rate of LVH can be as high as 75–89%
The purpose of this study was to explore the prevalence of LVH in Chinese MHD patients and the left ventricular geometry distribution determined by echocardiography, and to explore the risk factors of LVH to guide clinical treatment, so as to reduce the prevalence of LVH, and reduce the risk of cardiovascular events and cardiovascular death
Summary
To investigate the prevalence of left ventricular hypertrophy (LVH) and explore left ventricular geometry in maintenance hemodialysis (MHD) patients, and to explore the risk factors of LVH which is an important predictor of cardiovascular events. LVH is the most common cardiovascular abnormality in patients with chronic kidney disease (CKD) [6]. In non-dialysis dependent CKD patients, the prevalence of LVH is around 47%; while in ESKD patients, the prevalence rate of LVH can be as high as 75–89%. It is reported that the risk of LVH increases with dialysis vintage and patients with LVH tend to progress. LVH is often associated with a high risk of sudden cardiac death and is a predictor of cardiovascular death. The occurrence and continuous progression of LVH are associated with adverse cardiovascular prognosis and survival prognosis. The possible causes include anemia, hyperparathyroidism, toxin accumulation, malnutrition, etc., and volume overload and hypertension are still considered as important causes of LVH progression
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