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Echocardiographic and Clinical Characteristics Cross-Sectional Study in Association with Thai Peritoneal Dialysis
Insights
Echocardiographic alterations are common in Thai Continuous Ambulatory Peritoneal Dialysis (CAPD) patients, with high rates of left ventricular hypertrophy (LVH). Anemia is a key factor, but longer CAPD duration may improve cardiac structure.
Area of Science:
- Nephrology
- Cardiology
- Medical Imaging
Background:
- Dialysis patients exhibit cardiac structural and functional changes, identified by echocardiography, as predictors of outcomes.
- Limited data exists on echocardiographic alterations in Thai Continuous Ambulatory Peritoneal Dialysis (CAPD) patients.
- This study investigates the correlation between clinical and echocardiographic characteristics in Thai CAPD patients.
Purpose of the Study:
- To determine the correlation between baseline clinical and echocardiographic characteristics of Thai CAPD patients.
- To assess the prevalence of cardiac structural changes in Thai CAPD patients.
- To identify factors associated with left ventricular mass index (LVMI) variations.
Main Methods:
- A single-center, cross-sectional observational study.
- 104 CAPD outpatients were enrolled between September 2012 and June 2014.
- Demographic, echocardiographic, and laboratory data were collected and analyzed.
Main Results:
- 82.7% of patients showed elevated LVMI, higher in males than females.
- All patients presented with diastolic dysfunction (mostly Grade I).
- Male gender, hypertension, high phosphate, low hemoglobin, prolonged QT interval, and CAPD duration >24 months predicted LVMI variation.
Conclusions:
- Thai CAPD patients exhibit a higher prevalence of left ventricular hypertrophy (LVH) than previously reported.
- Anemia is an independent factor contributing to LVH development.
- Longer CAPD duration may lead to regression of LVH and reduced right ventricular systolic pressure (RVSP), warranting further prospective research.
Background:
The dialysis patients have a lot of changes in cardiac structure and function detected by echocardiography and they have been recognized as key outcome predictors. However, the available data regarding echocardiographic alterations in Thai Continuous Ambulatory Peritoneal Dialysis (CAPD) patients is limited. This study aimed to determine the correlation between baseline clinical and echocardiographic characteristics of Thai CAPD patients.
Material And Method:
This study was a single center and cross-sectional observational study, which enrolled all CAPD outpatients (104 patients), treated at Srinakharinwirot Medical University between 1 September 2012 and 31 June, 2014. Their demographic and echocardiographic data were collected one time and the latest laboratory data to the patient's echocardiographic study date were analyzed.
Results:
One hundred and four patients (50 men and 54 women) whose mean age was 59.4 ± 12.7 years and median duration of CAPD was 12 months were recruited. An extremely high prevalence of elevated left ventricular mass index (LVMI), 82.7% was found which mean LVMI was higher in male than female (166.2 ± 55.6 vs. 131 ± 47.6 g/m2). All patients had diastolic dysfunction and most ofthem had diastolic dysfunction grade I. The studyfactors of male gender, history of hypertension, high serum phosphate, low hemoglobin level, corrected QT interval, and duration of CAPD longer than 24 months can predict the variation of LVMI. Interestingly, the study found that a duration of CAPD of longer than 42 months might reduce right ventricular systolic pressure.
Conclusion:
This study revealed a higher prevalence of left ventricular hypertrophy (LVH) in Thai CAPD patients when compared with previous studies and anemia still be an important independentfactor for developing LVH. Longer period of CAPD may regress LVH and lower RVSP that should be proven by longer well-designed prospective studies.
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