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Association between aluminum accumulation and cardiac hypertrophy in hemodialyzed patients
G M London1, M C de Vernejoul, F Fabiani
1Centre Hospitalier F.H. Manhes, Fleury-Mérogis, France.
Insights
Aluminum accumulation in hemodialysis patients is linked to increased left ventricular mass (LVM). This study found aluminum load correlates with cardiac changes, suggesting a role in myocardial remodeling.
Area of Science:
- Nephrology
- Cardiology
- Toxicology
Background:
- Aluminum accumulation is a concern in patients undergoing long-term hemodialysis.
- The impact of aluminum on cardiac structure and function in these patients requires further investigation.
Purpose of the Study:
- To investigate the association between aluminum accumulation and myocardial status in hemodialysis patients.
- To assess the relationship between aluminum load parameters and left ventricular mass (LVM).
Main Methods:
- Echocardiography was used to assess cardiac status in 50 stable hemodialysis patients.
- Deferoxamine (DFO) test and bone biopsy were performed to quantify aluminum (AI) load.
- Parameters included serum AI increase post-DFO (delta AI DFO) and stainable cortical bone aluminum (SCBA).
Main Results:
- Patients with SCBA showed significantly different cardiac parameters compared to those without.
- Aluminum load (delta AI DFO and SCBA) correlated positively with LVM.
- These correlations were independent of dialysis duration, suggesting a direct link between aluminum and LVM.
Conclusions:
- Aluminum accumulation in hemodialysis patients is associated with increased left ventricular mass (LVM).
- The findings suggest aluminum may play a role in cardiac remodeling in this population.
- Further research is warranted to explore the clinical implications of aluminum-induced cardiac changes.
Abstract:
In order to investigate the possible role of aluminum accumulation on the myocardium, 50 stable asymptomatic hemodialysis patients were studied. Patient cardiac status was assessed by echocardiography. A deferroxamine (DFO) test, together with a bone biopsy, was performed to determine the magnitude of AI accumulation. Thus, an increase in serum AI after DFO (delta AI DFO) and stainable cortical bone aluminum (SCBA) were taken as parameters of AI load. Fourteen of 50 patients had no SCBA. They differed from the 36 patients with SCBA in that they had lower left ventricular mass (LVM) (P less than 0.001), increased velocity of circumferential fiber shortening (Vcf) (P less than 0.001), and higher mitral E-F slope (P less than 0.01). In the overall population there was a mild increment in serum AI and in delta AI DFO. The duration of dialysis treatment was correlated with SCBA and delta AI DFO (P less than 0.001). A correlation was observed between LVM and delta AI DFO (P less than 0.001) and between LVM and SCBA (P less than 0.001). Multivariate correlations analysis indicated that these relationships were independent of the duration of dialysis treatment. The present data suggest that, in hemodialysis patients aluminum accumulation may be associated with increased LVM.