Echocardiographic left ventricular hypertrophy and geometry in Chinese chronic hemodialysis patients: the prevalence and determinants

Abstract

Background To investigate the prevalence of left ventricular hypertrophy (LVH) and explore left ventricular geometry in maintenance hemodialysis (MHD) patients, and to explore the risk factors of LVH which is an important predictor of cardiovascular events. Methods The subjects were patients who are on MHD for more than 3 months in Peking University People's Hospital from March 2015 to February 2017. Demographic and clinical data were retrospectively collected. Left ventricular mass was measured by echocardiography. LVH is defined by Left ventricular mass index (LVMI) > 115 g/m2 for men and > 95 g/m2 in women. LVMI and relative wall thickness were used to determine left ventricular geometry. Logistic regression was used to analyze the risk factors of LVH. Results Altogether, 131 patients including 77 males were enrolled. The median age was 60 (47, 69) years, with a median dialysis vintage of 48 (18, 104) months. There were 80 patients with LVH, the prevalence rate was 61.1%, and 66.3% of them were moderate to severe LVH. We found that (1) most of the patients were concentric hypertrophy; (2) one-third of the patients were concentric remodeling; (3) only 4 cases with normal geometry. The pre-dialysis serum sodium level and time average pre-dialysis systolic blood pressure (SBP) were independent risk factors of LVH. Conclusion LVH is prevalent in MHD patients. Concentric hypertrophy and concentric remodeling are the most common geometric patterns. Attention should be paid to long-term pre-dialysis SBP management and pre-dialysis sodium control as they might be potentially modifiable risk factors for LVH.

Roxadustat reduces left ventricular mass index compared to rHuEPO in haemodialysis patients in a randomized controlled trial

“…LVMIs ≥115 g/m 2 in men and ≥95 g/m 2 in women were the criteria for LVH [5], with a baseline LVH prevalence of 72/114, including 43 in the roxadustat group with LVMI of 125.07 ± 25.36 g/m 2 and 29 in the EPO group with LVMI of 126.48 ± 18.66 g/m 2 , with no significant difference between the 2 groups ( p = 0.799). At 12 months of follow‐up, LVMI in the roxadustat group decreased to 115.50 ± 26.33 g/m 2 , and LVMI in the EPO group increased to 131.36 ± 27.6.8 g/m 2 , with a significant difference between the two groups ( p = 0.017).…”

“…The most apparent relationship between anaemia and cardiac disease is left ventricular hypertrophy (LVH) [2,3]. The prevalence of LVH in HD patients is as high as 61%-75% [4,5], and LVH is a significant predictor of cardiovascular mortality and morbidity in these patients. It is an independent risk factor for the development of arrhythmias, sudden death, heart failure and ischaemic heart disease, which sharply increases the risk of sudden cardiac death.…”

Monocyte to lymphocyte ratio as a predictor of left ventricular hypertrophy in end stage renal disease patients underlying hemodialysis

“…End-stage renal disease (ESRD) individuals most often experience cardiovascular disease (CVD), which accounts for around 50% of all fatalities [15] . The progression of cardiovascular events, including stroke, arrhythmia, LVH, atherosclerosis, and heart failure, is directly correlated with the occurrence of LVH [16] . A statistically substantial increase was existed in group 1 (with LVH) than group2 (without LVH) as regard HD duration (p-value ≤ 0.05).…”

Left ventricular geometry characteristics and clinical outcomes in hemodialysis patients with heart failure with preserved ejection fraction

“…The prevalence heart failure (HF) with preserved ejection fraction (HFpEF) in patients undergoing MHD is 40–76.5% [ 8 ]. Previous studies have described the mechanical and clinical causes of worsening LVG associated with chronic kidney disease (CKD) [ 9 , 10 ]. However, the relationships among left heart remodeling, cardiac diastolic and systolic function, and CEs in patients with HFpEF receiving MHD remain unclear [ 11 ].…”