Left Ventricular Hypertrophy (LVH) and Left Ventricular Geometric Patterns in Patients with Chronic Kidney Disease (CKD) Stage 2-5 With Preserved Ejection Fraction (EF): A Systematic Review to Explore CKD Stage-wise LVH Patterns

Maqbool, Shahzaib; Shafiq, Saba; Ali, Sarmad A; Rehman, Muhammad Ebad Ur; Malik, Jahanzeb; Lee, Ka Yiu

doi:10.1016/j.cpcardiol.2023.101590

Cited by 6 publications

(8 citation statements)

References 22 publications

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“…ESKD patients have a high risk of developing LVH, with a reported prevalence of 46.4%–65% ( 6 , 22 ), which is consistent with the findings of our study (51.0%). The prevalence and severity of LVH tend to increase with the deterioration of chronic kidney disease (CKD) stages ( 4 ). During ESKD, oxidative stress and inflammation are constantly present and are considered to be closely involved in the pathogenesis of LVH.…”

Section: Discussionmentioning

confidence: 99%

“…Left ventricular hypertrophy (LVH) is the most common cardiac abnormality and an adverse prognostic indicator for clinical cardiovascular outcomes including morbidity and mortality in ESKD patients ( 2 – 5 ). Although numerous studies have revealed that hypertension, fluid overload, oxidative stress and chronic inflammation directly or indirectly impinge upon cardiac hypertrophy and remodeling in ESKD patients ( 4 , 6 , 7 ), the pathogenesis of LVH is complicated and not fully understood yet. Emerging evidence suggests that involvement of immune system is associated with the development and progression of cardiac hypertrophy and remodeling ( 8 – 10 ).…”

Section: Introductionmentioning

confidence: 99%

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Machine learning-based investigation of the relationship between immune status and left ventricular hypertrophy in patients with end-stage kidney disease

Yang

Peng

Zhuang

et al. 2023

Front. Cardiovasc. Med.

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BackgroundLeft ventricular hypertrophy (LVH) is the most frequent cardiac complication among end-stage kidney disease (ESKD) patients, which has been identified as predictive of adverse outcomes. Emerging evidence has suggested that immune system is implicated in the development of cardiac hypertrophy in multiple diseases. We applied machine learning models to exploring the relation between immune status and LVH in ESKD patients.MethodsA cohort of 506 eligible patients undergoing immune status assessment and standard echocardiography simultaneously in our center were retrospectively analyzed. The association between immune parameters and the occurrence of LVH were evaluated through univariate and multivariate logistic analysis. To develop a predictive model, we utilized four distinct modeling approaches: support vector machine (SVM), logistic regression (LR), multi-layer perceptron (MLP), and random forest (RF).ResultsIn comparison to the non-LVH group, ESKD patients with LVH exhibited significantly impaired immune function, as indicated by lower cell counts of CD3+ T cells, CD4+ T cells, CD8+ T cells, and B cells. Additionally, multivariable Cox regression analysis revealed that a decrease in CD3+ T cell count was an independent risk factor for LVH, while a decrease in NK cell count was associated with the severity of LVH. The RF model demonstrated superior performance, with an average area under the curve (AUC) of 0.942.ConclusionOur findings indicate a strong association between immune parameters and LVH in ESKD patients. Moreover, the RF model exhibits excellent predictive ability in identifying ESKD patients at risk of developing LVH. Based on these results, immunomodulation may represent a promising approach for preventing and treating this disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Machine learning-based investigation of the relationship between immune status and left ventricular hypertrophy in patients with end-stage kidney disease

Yang

Peng

Zhuang

et al. 2023

Front. Cardiovasc. Med.

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“…Chronic kidney disease (CKD) has emerged as an increasingly important risk factor contributing to cardiovascular diseases (CVD), which is currently the leading cause of morbidity and mortality worldwide (1,2). Numerous epidemiological studies have reported a strong association between deteriorating renal function and ultimate outcomes of CVD, and severe CV events accounted for almost 50% of all deaths in the population with kidney disease (2)(3)(4). According to the 2019 Global Burden of Disease study, 15-20% of the world's population is affected by CKD, which is ranked the 12th leading risk factor affecting disability-adjusted life-years (5,6).…”

Section: Introductionmentioning

confidence: 99%

High sodium intake and fluid overhydration predict cardiac structural and functional impairments in chronic kidney disease

Duan,

Ma,

et al. 2024

Front. Nutr.

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BackgroundHigh sodium intake and fluid overhydration are common factors of and strongly associated with adverse outcomes in chronic kidney disease (CKD) patients. Yet, their effects on cardiac dysfunction remain unclear.AimsThe study aimed to explore the impact of salt and volume overload on cardiac alterations in non-dialysis CKD.MethodsIn all, 409 patients with CKD stages 1–4 (G1–G4) were enrolled. Daily salt intake (DSI) was estimated by 24-h urinary sodium excretion. Volume status was evaluated by the ratio of extracellular water (ECW) to total body water (TBW) measured by body composition monitor. Recruited patients were categorized into four groups according to DSI (6 g/day) and median ECW/TBW (0.439). Echocardiographic and body composition parameters and clinical indicators were compared. Associations between echocardiographic findings and basic characteristics were performed by Spearman’s correlations. Univariate and multivariate binary logistic regression analysis were used to determine the associations between DSI and ECW/TBW in the study groups and the incidence of left ventricular hypertrophy (LVH) and elevated left ventricular filling pressure (ELVFP). In addition, the subgroup effects of DSI and ECW/TBW on cardiac abnormalities were estimated using Cox regression.ResultsOf the enrolled patients with CKD, the median urinary protein was 0.94 (0.28–3.14) g/d and estimated glomerular filtration rate (eGFR) was 92.05 (IQR: 64.52–110.99) mL/min/1.73 m2. The distributions of CKD stages G1–G4 in the four groups was significantly different (p = 0.020). Furthermore, compared to group 1 (low DSI and low ECW/TBW), group 4 (high DSI and high ECW/TBW) showed a 2.396-fold (95%CI: 1.171–4.902; p = 0.017) excess risk of LVH and/or ELVFP incidence after adjusting for important CKD and cardiovascular disease risk factors. Moreover, combined with eGFR, DSI and ECW/TBW could identify patients with higher cardiac dysfunction risk estimates with an AUC of 0.704 (sensitivity: 75.2%, specificity: 61.0%). The specificity increased to 85.7% in those with nephrotic proteinuria (AUC = 0.713). The magnitude of these associations was consistent across subgroups analyses.ConclusionThe combination of high DSI (>6 g/d) and high ECW/TBW (>0.439) independently predicted a greater risk of LVH or ELVFP incidence in non-dialysis CKD patients. Moreover, the inclusion of eGFR and proteinuria improved the risk stratification ability of DSI and ECW/TBW in cardiac impairments in CKD.

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“…Cardiovascular diseases are the leading cause of death among patients with chronic kidney disease as the risk of cardiovascular diseases increases in CKD patients, particularly among patients with endstage renal failure (ESRD). 1 A significant association between the Glomerular filtration rate (GFR) and CVDs has been observed, as the decreasing GFR is considered a predictive factor for the development of CVD'S. 2 Various epidemiological studies have shown a paramount association between decreasing renal function and with ultimate outcomes of CVD's and mortality.…”

Section: Introductionmentioning

confidence: 99%

“…2 Various epidemiological studies have shown a paramount association between decreasing renal function and with ultimate outcomes of CVD's and mortality. 1 According to the statistics, the prevalence of CKD-associated cardiovascular diseases in the United Kingdom (UK) and the United States (US) was found to be 47.2% and 33.4% respectively. Studies have investigated various pre-existing factors like hypertension, diabetes mellitus, anemia, and dyslipidemia as the causative factors for an increased incidence of CKD-induced cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Left ventricular hypertrophy (LVH) in different stages of chronic kidney disease (CKD) patients and its correlation with anaemia

Tahara,

Dutta

2024

J. Bangladesh Coll. Phys.

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Background : Chronic kidney disease (CKD) is a public health problem that increases the risk of cardiovascular morbidity and mortality. Heart failure with preserved ejection fraction characterized by left ventricular hypertrophy (LVH) and diastolic dysfunction is a common cardiovascular complication of CKD. Anaemia is present in both dialysis & non dialysis CKD patients. Anaemia causes left ventricular hypertrophy (LVH) which in turn leads to increases morbidity and mortality in CKD, even before progression of chronic kidney disease (CKD) to end stage renal disease (ESRD). Our study is aimed at to evaluate the prevalence of left ventricular hypertrophy (LVH) and its correlation with anaemia in hospitalized CKD patients. Materials and Methods : A cross-sectional study was done on 50 patients of different stages of CKD admitted in the chittagong medical college hospital (CMCH). All the clinical data were reviewed and recorded. Data was analyzed by SPSS-18 and p value <0.05 was considered statistically significant. Results : Majority of study population 64% was male, 36% was female. Most of the male patient (40%) of the study population were having abnormal left ventricular mass index (>130 gm/m2). More patients with severe left ventricular hypertrophy were found in stage 5 of CKD in female and male which was 8 and 23 respectively. Regarding correlation of Hb% with LVMI there was a significant negative correlation was found (r= -0.420, p = 0.003) between them means if Hb% decreases LVMI level increases. It was also found in male and female patients separately ( for male r = -0.778, p = 0.001 and for female r = -0.746, p = 0.001). Conclusion : Anemia is widely prevalent in our CKD patients. Severity of anemia is correlated to left ventricular hypertrophy in these patients. Hence correction of anemia early in these group of patients can halt or prevent cardiovascular morbidity and mortality. J Bangladesh Coll Phys Surg 2024; 42: 25-30

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Left Ventricular Hypertrophy (LVH) and Left Ventricular Geometric Patterns in Patients with Chronic Kidney Disease (CKD) Stage 2-5 With Preserved Ejection Fraction (EF): A Systematic Review to Explore CKD Stage-wise LVH Patterns

Cited by 6 publications

References 22 publications

Machine learning-based investigation of the relationship between immune status and left ventricular hypertrophy in patients with end-stage kidney disease

Machine learning-based investigation of the relationship between immune status and left ventricular hypertrophy in patients with end-stage kidney disease

High sodium intake and fluid overhydration predict cardiac structural and functional impairments in chronic kidney disease

Left ventricular hypertrophy (LVH) in different stages of chronic kidney disease (CKD) patients and its correlation with anaemia

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