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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Correlation between endothelial dysfunction and left ventricular remodeling in patients with chronic kidney disease
1Department of Nephrology, Shandong University Qilu Hospital, Jinan 250012, China.
Insights
Endothelial dysfunction, marked by altered endothelin-1 and nitric oxide levels, significantly contributes to left ventricular hypertrophy in chronic kidney disease patients.
Area of Science:
- Cardiology
- Nephrology
- Vascular Biology
Background:
- Chronic kidney disease (CKD) is associated with cardiovascular complications.
- Endothelial dysfunction is a known complication of CKD.
Purpose of the Study:
- To investigate the role of endothelial dysfunction in left ventricular remodeling in CKD patients.
- To evaluate the correlation between endothelial dysfunction markers and left ventricular remodeling.
Main Methods:
- Compared 73 CKD patients with 30 healthy controls.
- Measured serum endothelin-1, nitric oxide, and inducible nitric oxide synthase.
- Assessed cardiac structure and function using echocardiography.
Main Results:
- CKD patients showed higher incidence of left ventricular hypertrophy (65%).
- Elevated endothelin-1 and nitric oxide, decreased inducible nitric oxide synthase observed in CKD.
- Positive correlation between endothelin-1 and left ventricular mass/thickness; negative correlation between nitric oxide and diastolic function.
Conclusions:
- CKD is linked to a high prevalence of left ventricular hypertrophy.
- Endothelin-1 and nitric oxide are key factors in the development of left ventricular hypertrophy in CKD.
Background/Aims:
To investigate the role of endothelial dysfunction on left ventricular remodeling in patients with chronic kidney disease and to evaluate the correlation between endothelial dysfunction and left ventricular remodeling.
Methods:
Seventy-three patients with chronic kidney disease as study-group and thirty healthy volunteers as control-group were enrolled in the present study. All patients in both groups had echocardiography examination. The concentration of endothelin-1, nitric oxide, and inducible nitric oxide synthase of serum of all patients and healthy volunteers was measured. The incidence of cardiac structural abnormalities in patients with chronic kidney disease, and the relationship between endothelial dysfunction and cardiac structural abnormalities were analyzed.
Results:
The incidence of left ventricular hypertrophy, left ventricular concentric remodeling, and left ventricular systolic dysfunction was 65%, 8.33%, and 16.67%, respectively. The level of endothelin-1 and nitric oxide increased in study-group, and the concentration of inducible nitric oxide synthase decreased. There was significant positively relationship between plasma endothelin-1 and left ventricular mass index, interventricular septal thickness, left ventricular diastolic diameter. There was negatively relationship between the level of serum nitric oxide and the maximum flow velocity at the mitral in left ventricular diastolic stage. There was not any correlation between inducible nitric oxide synthase with left ventricular remodeling.
Conclusions:
The results showed that there was a higher incidence of left ventricular hypertrophy in patients with chronic kidney disease. Endothelin-1 and nitric oxide played an important role on the development of left ventricular hypertrophy.
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