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No association between deletion-type angiotensin-converting enzyme gene polymorphism and left-ventricular hypertrophy
A Yildiz1, V Akkaya, A C Hatemi
1Department of Internal Medicine, Experimental Medicine Center, University of Istanbul, Istanbul Faculty of Medicine, Istanbul, Turkey.
Insights
Left-ventricular hypertrophy (LVH) in hemodialysis patients is linked to hypertension, anemia, and dialysis duration. The angiotensin-converting enzyme (ACE) DD genotype did not influence LVH development in this patient group.
Area of Science:
- Nephrology
- Cardiology
- Genetics
Background:
- Left-ventricular hypertrophy (LVH) is a significant negative prognostic indicator frequently observed in patients undergoing hemodialysis.
- Understanding the factors contributing to LVH is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the factors associated with the development of LVH in hemodialysis patients.
- Specifically, to analyze the potential impact of angiotensin-converting enzyme (ACE) genotype on LVH.
Main Methods:
- The study included 79 hemodialysis patients and 82 healthy controls, assessing left-ventricular mass index (LVMI).
- Factors analyzed included blood pressure, time on dialysis, hemoglobin levels, age, predialytic creatinine, albumin, and ACE genotype.
- Statistical analyses, including univariate and multivariate analyses, were performed to identify predictors of LVMI.
Main Results:
- Hemodialysis patients exhibited significantly higher LVMI compared to controls.
- Elevated LVMI was observed in hypertensive hemodialysis patients compared to normotensive ones.
- Multivariate analysis identified blood pressure, time on dialysis, and hemoglobin levels as significant predictors of LVMI. No correlation was found between LVMI and ACE genotype.
Conclusions:
- LVH in hemodialysis patients is primarily associated with hypertension, anemia, and the duration of dialysis.
- The ACE DD genotype does not appear to influence LVMI in this population.
Abstract:
Left-ventricular hypertrophy (LVH), a bad prognostic sign, is a common finding in hemodialysis patients. The aim of the study was to analyze factors, including angiotensin-converting enzyme (ACE) genotype that may have an effect on the development of LVH in hemodialysis patients. Seventy-nine hemodialysis patients (42 males, 37 females, mean age 37.7 +/- 13.1 years) and 82 age- and sex-matched normotensive healthy controls (40 males, 42 females, mean age 35.6 +/- 5.7 years) were included. Left-ventricular mass index (LVMI) was higher in the hemodialysis group compared to controls (170.1 +/- 69.3 versus 84.9 +/- 15.7 g/m(2), p < 0.001). Fourty-three hypertensive patients in the hemodialysis group had an increased LVMI compared to 36 normotensive hemodialysis patients (194.2 +/- 75.5 versus 141.2 +/- 48.0 g/m(2), p < 0.001). On univariate analysis, LVMI was found to be correlated with blood pressure (r = 0.38, p < 0.001), time spent on dialysis (r = 0.22, p = 0.02) and hemoglobin levels (r = -0.21, p = 0.03). No correlation was found between LVMI and age (r = 0.09, p = 0.22), predialytic creatinine (r = 0.09, p = 0.21) and albumin (r = -0.10, p = 0.18). On multivariate analysis for the predictors of LVMI, blood pressure, time spent on dialysis and hemoglobin levels were also found to be significant. LVMI in DD, ID and II genotypes were 155.0 +/- 71.2, 181.6 +/- 60.6, and 163.6 +/- 83.4 g/m(2), respectively (p > 0.05). No association between LVMI and DD genotype was found. ACE genotype distribution was similar in hemodialysis patients and healthy controls. It was concluded that LVH in hemodialysis patients was mainly related to hypertension, anemia and time spent on dialysis and the DD genotype had no effect on LVMI in hemodialysis patients.