Left ventricular hypertrophy and risk factors for its development in uraemic patients

Senija Rasić,Amra Catović,Azra Haracić,Indira Kulenović

doi:10.17305/bjbms.2004.3458

Senija Rasić, Amra Catović + Show 2 more

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https://doi.org/10.17305/bjbms.2004.3458

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Abstract

Cardiovascular diseases are the major cause of mortality in uraemic patients treated by hemodialysis. Left ventricular hypertrophy (LVH) is considered to be a major cardiac risk factor. To investigate the presence of some potential adverse risk factors in hemodialysis patients with developed LVH echocardiography verified and determine their relative contribution to the LVH in comparison with patients with normal LV. The study included 50 patients with end-stage renal disease in the first 2 years of hemodialysis treatment, who were followed up during one year. All participants have the echocardiography performed as well as serial measurements of potential modifiable cardiovascular risk factors. This investigation showed that LVH is present in high percentage (72%) in uraemic patients, even at the beginning of hemodialysis treatment. This LV morphological abnormality is statistically significantly related to anaemia (p<0,001), systolic (p<0,001) and diastolic hypertension (p<0,001)), elevated mean arterial pressure (p<0,001) and hyperparathyroidism (p=0,002). Modification of existing risk factors in uraemic patients could contribute to prevention and treatment of LV hypertophy and thus reduce cardiovascular morbidity and mortality.

Highlights

Left ventricular hypertrophy (LVH) is commonly present in uraemic patients and it has been recognized as adaptive mechanism of left ventricle (LV) on volume and pressure overload (1)
It is especially associated with high mortality of uraemic patients (2,3) and presents an independent risk factor of adversely impact on outcome in praedialysis, as an in haemodialysis patients
It is shown that the average age was over 40 years in all groups, with lowest values in the group with normal LV function, and without statistically significant difference regarding age between the groups with concentric and eccentric LVH

Summary

Introduction

Left ventricular hypertrophy (LVH) is commonly present in uraemic patients and it has been recognized as adaptive mechanism of LV on volume and pressure overload (1). It is especially associated with high mortality of uraemic patients (2,3) and presents an independent risk factor of adversely impact on outcome in praedialysis, as an in haemodialysis patients. In concentric hypertrophy of LV myocytes increase in thickness. The increased LV mass is associated with increased thickness of both the interventricular septum and left ventricular posterior wall, with preserved normal ventricular volume. In concentric LV hypertrophy, the relative wall thickness is higher than 45%. In eccentric LV hypertrophy myocytes grow longitudinally, and the increased LV mass is associated with increased LV volume

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