Related Experiment Video
Updated: May 3, 2026
Author Spotlight: Enhancing Graft Viability Assessment Through Quantitative Metrics and Innovative Reservoir Systems
Published on: August 2, 2024
Left ventricular mass in dialysis patients, determinants and relation with outcome. Results from the COnvective
Ira M Mostovaya1, Michiel L Bots2, Marinus A van den Dorpel3
1Department of Nephrology, University Medical Center Utrecht, Utrecht, the Netherlands.
Insights
High left ventricular mass (LVM) in end-stage kidney disease (ESKD) patients is linked to increased mortality, especially sudden death. Biomarkers of inflammation and fibrosis were not associated with LVM.
Area of Science:
- Cardiology
- Nephrology
- Clinical Research
Background:
- Left ventricular mass (LVM) is a known predictor of mortality in end-stage kidney disease (ESKD) patients.
- Studies indicate a relationship between LVM and both overall and cardiovascular mortality in this population.
Purpose of the Study:
- To investigate the association between LVM and mortality and cardiovascular events in ESKD patients.
- To identify determinants of LVM, including biomarkers of inflammation and fibrosis.
Main Methods:
- Analysis of data from 327 ESKD patients from the CONvective TRAnsport STudy (CONTRAST).
- Echocardiography at baseline to assess LVM.
- Cox regression and multivariable linear regression analyses to determine associations.
Main Results:
- The highest tertile of LVM was associated with increased risk of all-cause mortality (HR=1.73), cardiovascular death (HR=3.66), and sudden death (HR=13.06).
- Factors positively related to LVM included male gender, residual renal function, and phosphate binder therapy.
- Previous kidney transplantation and albumin levels showed an inverse relationship with LVM.
- Biomarkers such as IL-6, hsCRP, hepcidin-25, and CTGF were not found to be related to LVM.
Conclusions:
- A high LVM is confirmed to be related to adverse outcomes, including a significantly increased risk of sudden death in ESKD patients.
- No association was found between LVM and markers of inflammation or fibrosis in this cohort.
Background And Objectives:
Left ventricular mass (LVM) is known to be related to overall and cardiovascular mortality in end stage kidney disease (ESKD) patients. The aims of the present study are 1) to determine whether LVM is associated with mortality and various cardiovascular events and 2) to identify determinants of LVM including biomarkers of inflammation and fibrosis.
Design Setting Participants & Measurements:
Analysis was performed with data of 327 ESKD patients, a subset from the CONvective TRAnsport STudy (CONTRAST). Echocardiography was performed at baseline. Cox regression analysis was used to assess the relation of LVM tertiles with clinical events. Multivariable linear regression models were used to identify factors associated with LVM.
Results:
Median age was 65 (IQR: 54-73) years, 203 (61%) were male and median LVM was 227 (IQR: 183-279) grams. The risk of all-cause mortality (hazard ratio (HR) = 1.73, 95% CI: 1.11-2.99), cardiovascular death (HR = 3.66, 95% CI: 1.35-10.05) and sudden death (HR = 13.06; 95% CI: 6.60-107) was increased in the highest tertile (>260 grams) of LVM. In the multivariable analysis positive relations with LVM were found for male gender (B = 38.8±10.3), residual renal function (B = 17.9±8.0), phosphate binder therapy (B = 16.9±8.5), and an inverse relation for a previous kidney transplantation (B = -41.1±7.6) and albumin (B = -2.9±1.1). Interleukin-6 (Il-6), high-sensitivity C-reactive protein (hsCRP), hepcidin-25 and connective tissue growth factor (CTGF) were not related to LVM.
Conclusion:
We confirm the relation between a high LVM and outcome and expand the evidence for increased risk of sudden death. No relationship was found between LVM and markers of inflammation and fibrosis.
Trial Registration:
Controlled-Trials.com ISRCTN38365125.
Related Concept Videos
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...