Predictive Factors Associated with Left Ventricular Hypertrophy at Baseline and in the Follow‐Up Period in Non‐Diabetic Hemodialysis Patients

Abstract

Hemodialysis (HD) patients frequently have an elevated left ventricular mass index (LVMI). Currently, left ventricular (LV) hypertrophy and dysfunction are considered to be the strongest predictors of cardiovascular mortality in dialysis patients. The objectives of the present study are to investigate the factors associated with elevated LVMI and to discuss therapeutic implications for the treatment strategy for pre-dialysis and HD patients. The correlation among biochemical values, physical specimens, and LVMI using echocardiography was prospectively analyzed in 30 non-diabetic HD patients in the Juntendo University Hospital. Measurement of these parameters was performed at 0, 12, and 24 months after initiation of HD. Systolic blood pressure (SP), human atrial natriuretic peptide (hANP), and hemoglobin (Hb) levels were significantly correlated with LVMI. SBP, residual glomerular filtration rate (rGFR), and serum albumin levels were identified as independent risk factors for LVMI in multivariate regression analysis at initiation of HD. SBP, hANP, and Hb levels were identified as independent risk factors for LVMI in multivariate regression analysis after 24 months. SBP, rGFR, and serum albumin levels were predictive factors for LVMI at initiation of HD. SBP, hANP, and Hb levels were also predictive factors for LVMI after initiation of HD.

Pathogenesis and Treatment of Chronic Kidney Disease: A Review of Our Recent Basic and Clinical Data

“…Nakatani et al [136] showed that the plasma ANP level is one of the most important risk predictors of LV hypertrophy. The correlation between plasma ANP and LV mass was observed previously [124,125,134,135]. It has been hypothesized that left atrium (LA) size represents the integration of LV diastolic performance (compliance) over time.…”

“…In our study, the mean Hb level was significantly improved after initiation of HD, and this was maintained during the observation period. The LVMI tended to decrease after 24 months in our study [134]. Comparable BP control between the groups may have mitigated the potential development of LV hypertrophy.…”

“…We have examined cardiovascular function in CKD patients using ultrasonography [124,125,134,135]. Nakatani et al [136] showed that the plasma ANP level is one of the most important risk predictors of LV hypertrophy.…”

Determinants of Cardiovascular Risk in Hemodialysis Patients Without Significant Comorbidities

“…Systolic blood pressure, human atrial natriuretic peptide, and hemoglobin levels were independent risk factors for left ventricular mass index, after 24 months. Systolic blood pressure, human atrial natriuretic peptide, and hemoglobin levels were also predictive factors for left ventricular mass index after initiation of hemodialysis (Io et al, 2010). Better management of hypertension and anaemia may be priorities for preventing or improving CV risk in these patients.…”

Effects of Cardiac Function with Postoperative Arteriovenous Fistula Blood Flow in Patients with Hemodialysis

“…Echocardiographic examinations were performed in all patients as previously described [4,11] using a Toshiba ultrasound system (model 260 SS-A equipped with a 2.5-MHz phased array transducer; Tokyo, Japan). All examinations were performed in the left lateral recumbent position, and all data were evaluated according to the guidelines of the American Society of Echocardiography [12].…”