Related Experiment Video
Updated: Jun 10, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Left ventricular geometry and cardiovascular mortality based on haemodialysis patient autopsy analyses
Imari Mimura1, Hiroshi Nishi, Naobumi Mise
1Division of Nephrology and Endocrinology, University of Tokyo School of Medicine, Tokyo, Japan.
Insights
Eccentric left ventricular hypertrophy (LVH) in patients undergoing hemodialysis is linked to cardiovascular death. LVH geometry, not just severity, can predict mortality in these patients.
Area of Science:
- Nephrology
- Cardiology
- Pathology
Background:
- Left ventricular hypertrophy (LVH) is prevalent in end-stage renal disease (ESRD) patients, posing a significant risk for cardiovascular events.
- Eccentric LVH is associated with poorer outcomes in ESRD compared to concentric LVH.
- Limited autopsy studies have explored the link between LVH geometry and mortality in ESRD patients.
Purpose of the Study:
- To investigate the relationship between left ventricular hypertrophy (LVH) geometry and mortality in patients with end-stage renal disease (ESRD).
- To analyze autopsy findings in ESRD patients to determine if LVH geometry is a predictor of cardiovascular mortality.
Main Methods:
- An observational autopsy study was conducted on 30 hemodialysis patients (2001-2006).
- Compared heart/bodyweight ratio, left ventricular dilatation, and left ventricular fibrosis between cardiovascular and non-cardiovascular death groups.
Main Results:
- Patients who died from cardiovascular causes had significantly higher heart/bodyweight ratios (11.7 g/kg vs. 8.05 g/kg).
- Left ventricular dilatation was more frequent in the cardiovascular death group (P = 0.016).
- A larger fibrotic area was observed in the left ventricle of the cardiovascular death group (1.63% vs. 0.83%, P = 0.04).
Conclusions:
- Eccentric left ventricular hypertrophy (LVH) in hemodialysis patients is strongly associated with cardiovascular mortality.
- LVH geometry, alongside LVH severity, should be considered a valuable clinical predictor for cardiovascular mortality in ESRD patients.
Aim:
In end-stage renal disease (ESRD) patients, left ventricular hypertrophy (LVH) is common and a risk for cardiovascular events. LVH is geometrically classified into two major groups, concentric and eccentric, and accumulating evidence suggests eccentric LVH has a more negative effect than concentric LVH on ESRD outcome. However, there have been very few studies on the cardiac findings from ESRD patient autopsy in which the relationship between LVH geometry and mortality was analyzed.
Methods:
An observational study was performed with the autopsy findings in 30 haemodialysis patient cases between 2001 and 2006 at Mitsui Memorial Hospital, Tokyo. Between those who died of a cardiovascular cause and those who died of non-cardiovascular causes, we compared the heart/bodyweight ratio, left ventricular dilatation, and the extent of fibrosis of the left ventricle.
Results:
Heart/bodyweight ratio was significantly higher (P < 0.0001) in the cardiovascular mortality group (n = 11, 11.7 +/- 2.5 g/kg) compared to the non-cardiac cause of death group (n = 19, 8.05 +/- 0.7 g/kg). The dilatation of the left ventricle was significantly more frequent in the cardiovascular than the non-cardiac cause of death group (P = 0.016). Additionally, the fibrotic area of left ventricular cross-section was larger in the cardiovascular (1.63 +/- 1.6%) than the non-cardiac group (0.83 +/- 1.7%, P = 0.04).
Conclusion:
This autopsy study indicates that eccentric LVH in haemodialysis patients is closely associated with cardiovascular mortality. LVH geometry, as well as LVH severity, is worthy of consideration as a clinical predictor for cardiovascular mortality.
