Abstract
High prevalence of left ventricular hypertrophy (LVH) and elevated oxidative stress are associated with poor outcomes in chronic hemodialysis patients. Abnormal left ventriculаr geomеtry and different geometric patterns play an important role as well. Our study analyzed the role of oxidative stress on myocardial remodeling in these patients. Plasma malondialdehyde (MDA), protein carbonyl (PC) content, and total antioxidative capacity (TAC) were investigated in 104 hemodialysis patients together with transthoracic echocardiography. Compared to patients with normal ventricular geometry, patients with LVH had increased MDA and PC plasma concentration. Multivariate analysis demonstrated that protein carbonyls, as biomarkers of oxidative protein modification, were an independent predictor of eccentric hypertrophy (eLVH), including higher LV end-diastolic diameter and LV end-diastolic volume, (β = 0.32 and β = 0.28, p < 0.001 for both). The incidence of eLVH increased progressively from the lowest to the highest baseline PC tertile (p < 0.001 for the trend) and the subjects in the former group showed a 76% greater risk of developing eLVH compared to their counterparts. After further adjustment for the potential mediators, PCs carried eLVH odds (95% confidence interval (CI)) of 1.256 (0.998–1.514), per standard deviation increase. High plasma protein carbonyls levels are a significant independent predictor of eccentric LVH in chronic hemodialysis patients.
Highlights
Left ventricular hypertrophy (LVH) is a common structural change in chronic kidney disease patients with an estimated prevalence between 40% and 75%, dependent upon the chronic kidney disease (CKD) stage [1,2] and represents a strong predictor of cardiovascular (CV) morbidity and mortality
As eccentric hypertrophy is largely due to volume overload, we further examined the correlation between the protein carbonyl level and IDWG and found a significant positive correlation (r = 0.234, r = 0.017)
The results obtained in this investigation confirmed that oxidative stress parameters might be related to the prognosis of the morphological alterations of left ventricular (LV) geometry
Summary
Left ventricular hypertrophy (LVH) is a common structural change in chronic kidney disease patients with an estimated prevalence between 40% and 75%, dependent upon the chronic kidney disease (CKD) stage [1,2] and represents a strong predictor of cardiovascular (CV) morbidity and mortality. To the myocardial mass gain, abnormal left ventricular geomеtry is linked to poor outcome in chronic dialysis patients [3], and different geometric patterns (concentric or eccentric hypertrophy and concentric remodeling) play an important role as well [4,5,6,7]. Diagnostics 2019, 9, 202 ventricular hypertrophy is influenced by differences in the ventricular wall strain and the type of wall stress. Variations between the two types of hypertrophic phenotype in relation to gene and protein expression, signaling transduction pathways, and the release of the local hormones was observed
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