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Published on: February 7, 2015
Carotid intima-media thickness and left ventricular hypertrophy in hemodialysis patients
Mahmoud Rafieian-Kopaei1, Hamid Nasri2
1Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Insights
Cardiovascular disease in hemodialysis patients is linked to left ventricular hypertrophy (LVH) and intima-media thickening (IMT). Higher LVH stages correlate with longer hemodialysis, hypertension, and IMT, especially in diabetics.
Area of Science:
- Cardiology
- Nephrology
- Vascular Biology
Background:
- End-stage renal disease (ESRD) patients on hemodialysis commonly exhibit cardiovascular issues.
- Key findings include left ventricular hypertrophy (LVH) and arterial disease, characterized by intima-media complex thickening (IMT).
Purpose of the Study:
- To investigate the relationship between left ventricular hypertrophy (LVH) and intima-media complex thickening (IMT).
- Focus on end-stage renal disease (ESRD) patients undergoing regular hemodialysis.
Main Methods:
- Studied 61 ESRD patients on maintenance hemodialysis (50 non-diabetic, 11 diabetic).
- Utilized echocardiography and B-mode ultrasonography to measure carotid intima-media thickness (IMT).
Main Results:
- Positive correlation found between LVH stages and hemodialysis duration, hypertension (HTN) stages, and carotid IMT.
- LVH correlated with chest pain; diabetic patients showed greater IMT. Diabetes was linked to chest pain.
- Hypertension stages correlated with IMT; IMT showed a reverse correlation with cardiac ejection fraction.
Conclusions:
- Intima-media complex thickening (IMT) is more prevalent in hemodialysis subjects with left ventricular hypertrophy (LVH).
- The severity of IMT is comparable to LVH severity when LVH is present.
Introduction:
Two principal findings of cardiovascular disease in end-stage renal disease patients undergoing regular hemodialysis are left ventricular hypertrophy (LVH) and arterial disease due to rapidly progressive atherosclerotic vascular disease that can be characterized by an enlargement and hypertrophy of arteries (intima-media complex thickening; IMT).
Objectives:
In this study, we sought to evaluate the relationship between left ventricular hypertrophy with intima-media complex thickening in end-stage renal disease patients undergoing regular hemodialysis.
Patients And Methods:
Sixty-one patients with end-stage renal disease (ESRD) who were undergoing regular and maintenance hemodialysis treatment (F=23, M=38) were studied. The subjects consisted of 50 non-diabetic hemodialysis patients (F=20, M=30) and 11 diabetic hemodialysis patients (F=3, M=8). For all the subjects, echocardiography and carotid intima-media thickness measuring by B-mode ultrasonography were performed.
Results:
In this study, there was a positive correlation between stages of LVH with duration of hemodialysis treatment, stages of hypertension (HTN), and with carotid-IMT. A positive correlation was also seen between stages of LVH and presence of chest pain, and more thickening of the intima-media complex was seen in the diabetic group. Diabetes mellitus was associated with the presence of chest pain, as was positive correlation between stages of HTN with IMT, and a reverse correlation was observed between IMT with the percent of cardiac ejection fraction.
Conclusion:
Prevalence of thickening in intima-media complex is more evident in hemodialysis subjects with LVH. When there is LVH, IMT is similar in severity to the LVH.
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