The worsening of left ventricular hypertrophy is the strongest predictor of sudden cardiac death in haemodialysis patients: a 10 year survey

Paoletti, Ernesto; Specchia, Claudia; Maio, Giovanni Di; Bellino, Diego; Damasio, Maria Beatrice; Cassottana, Paolo; Cannella, Giuseppe

doi:10.1093/ndt/gfh288

Cited by 153 publications

(109 citation statements)

References 26 publications

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“…Elevated SBP and reduced DBP lead to increased PP, and elevations in PP lead to LVH. 13) Rizzo, et al 14) suggested that elevated ambulatory PP can be considered an effective predictor of cardiovascular risk in hypertensive subjects. In these patients echocardiographic evaluation of LV function and morphology can increase the prognostic value of PP.…”

Section: Discussionmentioning

confidence: 99%

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Left Ventricular Hypertrophy, Diastolic Dysfunction, Pulse Pressure, and Plasma ET-1 in Marathon Runners With Exaggerated Blood Pressure Response

et al. 2013

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SummaryThis study was conducted to study left ventricular hypertrophy (LVH), diastolic dysfunction, pulse pressure (PP), and plasma endothelin (ET)-1 level in amateur marathon runners with an exaggerated blood pressure response (EBPR) to exercise. The study participants included normotensive marathon runners (NM, n = 15), EBPR marathon runners (EBPR, n = 17), normotensive sedentary individuals (CON, n = 13), and hypertensive patients (HTN, n = 14). An integrated M-mode/2-dimensional echocardiographic analysis was performed. Plasma ET-1 levels at resting were measured using a commercial ELISA kit. LV wall thickness and end-diastolic dimensions as well as LV mass index (LVMI) were higher in EBPR than in CON. There were no differences in systolic function among the groups. Analysis of diastolic function, such as lower Em and higher E/Em ratio on TDI, showed a worse relaxation pattern in EBPR. Despite LVH, NM subjects showed no abnormality of LV diastolic dysfunction. HTN subjects in the early stage of their disease showed a slightly modified LV structural and diastolic function, but there was no statistical difference compared with CON. The E/Em ratio was significantly correlated with PP and LVMI. LVMI was significantly correlated with PP. There was a significant difference in plasma ET-1 concentration between marathon runners and hypertensive subjects. We demonstrated that marathon runners with EBPR showed an increase in LVMI and diastolic dysfunction more than HTN subjects in the early stage. PP was significantly related to these two variables. Caution should be exercised when connecting LVH and diastolic dysfunction with plasma ET-1 concentration in all marathon runners. (Int Heart J 2013; 54: 82-87)Key words: Endothelin-1, Marathon A thlete's heart is a well known condition characterized by structural, electrical, and functional adaptations of the myocardium consequent to regular physical training and consistent with the intensity, duration, and type of activity.1,2) To date, conflicting data have been reported concerning the nature (physiologic versus pathologic) of left ventricular hypertrophy (LVH) in master athletes and veterans. [3][4][5][6] Exaggerated blood pressure response (EBPR) during exercise is associated with increased risk of worsening hypertension in normotensives, as well as in subjects with high normal blood pressure (BP). 7,8) Moreover, EBPR might be related to adverse cardiovascular outcomes, partially due to its association with indices of target-organ damage such as LVH, abnormal geometry, or carotid atherosclerosis. [9][10][11] In addition, diastolic dysfunction of the LV frequently accompanies EBPR. 12)However, we do not know whether EBPR in athletes would show the same features associated with abnormal LV remodeling and diastolic dysfunction. Recently, we have unofficially found numerous cases of EBPR to exercise in Korean nonathletic marathon runners. Marathons have become a popular leisure activity in Korea during the last 2 decades and rank first in popularity as a public sport. We t...

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Section: Discussionmentioning

confidence: 99%

“…In addition, we investigated the pulse pressure (PP) and plasma endothelin (ET)-1 level. It is well known that PP is associated with LVH [13][14][15] and diastolic dysfunction. 12,16) Increased ET-1 production has unfavorable effects on the arterial walls, 17) and endothelial dysfunction is related to the LVH and diastolic function.…”

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confidence: 99%

Left Ventricular Hypertrophy, Diastolic Dysfunction, Pulse Pressure, and Plasma ET-1 in Marathon Runners With Exaggerated Blood Pressure Response

et al. 2013

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“…Two distinct patterns of LV remodelling are seen in CKD patients: concentric LVH, resulting from pressure overload, as seen with hypertension [83,100], and eccentric LVH that is related to volume overload, sodium retention and anaemia [83]. LVH leads to a decreased coronary reserve and arrhythmias [101], which, in turn, are responsible for a disturbing 1,000-fold increase in cardiovascular mortality in CKD stage 5 patients [59].…”

Section: Anaemiamentioning

confidence: 99%

Long-term outcome of chronic dialysis in children

et al. 2005

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As the prevalence of children on renal replacement therapy (RRT) increases world wide and such therapy comprises at least 2% of any national dialysis or transplant programme, it is essential that paediatric nephrologists are able to advise families on the possible outcome for their child on dialysis. Most children start dialysis with the expectation that successful renal transplantation is an achievable goal and will provide the best survival and quality of life.

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“…A chronic state of volume and pressure overload is a major contributor [2][3][4][5] leading to hypertension, left ventricular hypertrophy [6][7][8][9][10], and death [11,12]. Considerable research has evaluated the effect of dialysis frequency and duration on clinical outcomes [6,[13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Clinical Effects of Personalized Dialysate Sodium in Conventional, Quotidian, and Nocturnal Home Hemodialysis Patients: A Randomized Crossover Trial

Thomson¹,

Li²,

Lindsay³

2017

J Clin Exp Nephrol

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The worsening of left ventricular hypertrophy is the strongest predictor of sudden cardiac death in haemodialysis patients: a 10 year survey

Abstract: While confirming the role of common CV risk factors for SCD in dialysis patients such as IHD and arterial hypertension, this study is the first to demonstrate that the worsening of LVH is the strongest predictor of sudden death.

Cited by 153 publications

References 26 publications

Left Ventricular Hypertrophy, Diastolic Dysfunction, Pulse Pressure, and Plasma ET-1 in Marathon Runners With Exaggerated Blood Pressure Response

Left Ventricular Hypertrophy, Diastolic Dysfunction, Pulse Pressure, and Plasma ET-1 in Marathon Runners With Exaggerated Blood Pressure Response

Long-term outcome of chronic dialysis in children

Clinical Effects of Personalized Dialysate Sodium in Conventional, Quotidian, and Nocturnal Home Hemodialysis Patients: A Randomized Crossover Trial

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