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Published on: July 19, 2018
Serum apolipoprotein B is inversely associated with eccentric left ventricular hypertrophy in peritoneal dialysis
Min Ye1, Yanqiu Liu1, Haoyu Wang2
1Department of Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
Insights
Low serum apolipoprotein B (apo B) levels are linked to left ventricular (LV) dilatation in patients undergoing peritoneal dialysis (PD). This finding suggests apo B may help identify patients with eccentric LV remodeling and cardiovascular risk.
Area of Science:
- Cardiology
- Nephrology
- Biochemistry
Background:
- Cardiovascular disease is a leading cause of mortality in end-stage renal disease (ESRD) patients undergoing peritoneal dialysis (PD).
- Left ventricular (LV) remodeling, particularly eccentric remodeling, is a significant predictor of adverse cardiovascular outcomes in this population.
- The role of specific lipid parameters, such as apolipoprotein B (apo B), in LV remodeling in PD patients requires further elucidation.
Purpose of the Study:
- To investigate the association between serum apolipoprotein B (apo B) levels and left ventricular (LV) structural and functional characteristics.
- To specifically examine the relationship between serum apo B and LV remodeling parameters in patients undergoing PD.
Main Methods:
- A cohort of 182 end-stage renal disease (ESRD) patients receiving PD was analyzed.
- Conventional echocardiography was performed to assess LV structural and functional parameters.
- Multivariate linear regression models were employed to determine the association between serum apo B levels and LV remodeling indices, adjusting for confounding factors.
Main Results:
- Higher serum apo B levels were significantly inversely correlated with left atrium dimension, LV dimensions, and LV volumetric dimensions.
- Serum apo B was an independent determinant of LV dilatation, even after adjusting for conventional lipids and cardiovascular risk factors.
- Conventional lipid profiles were not significantly associated with LV eccentric remodeling, highlighting the unique role of apo B.
Conclusions:
- Serum apolipoprotein B (apo B) is significantly and inversely associated with left ventricular (LV) dilatation in ESRD patients on PD.
- Low serum apo B may serve as a potent risk marker for eccentric LV geometry remodeling.
- Apo B could potentially be utilized for risk stratification of PD patients, independent of traditional lipid profiles and cardiovascular risk factors.
Objectives:
The study aimed to examine the relationship of serum apolipoprotein B level with left ventricular (LV) structural and functional characteristics, in particular, LV remodeling parameters in peritoneal dialysis (PD) patients.
Methods:
A total of 182 patients with end-stage renal disease (ESRD) receiving PD were identified. Conventional echocardiography was performed for each patient, and echocardiographic characteristics were analyzed according to apo B quartile groups. Multivariate linear regression models were used to determine the associations between serum apo B and LV remodeling indices.
Results:
A high serum apo B level was significantly related to the reduction in left atrium dimension (r = - 0.20, P = 0.011), LV dimensions (end-diastolic: r = - 0.27, P = 0.001; end-systolic: r = - 0.24, P = 0.003), peak velocities of early filling divided by peak velocities of atrial filling (r = - 0.38, P < 0.001), and LV volumetric dimension (end-diastolic: r = - 0.27, P < 0.001; end-systolic: r = - 0.28, P < 0.001). After adjustment for clinical confounding factors, the effect of serum apo B on LV eccentric remodeling modestly weakened but remained statistically significant (P = 0.038), while other associations were not significant. In multivariate linear regression analysis, conventional lipid profiles were not significantly associated with LV eccentric remodeling, whereas serum apo B was an independent determinant of LV dilatation (β: - 42.10, 95% CI - 74.82 to - 9.38, P = 0.012).
Conclusions:
Serum apo B was significantly and inversely associated with LV dilatation, independently of conventional lipids and other CV risk factors in our ESRD patients undergoing PD. It suggested that low serum apo B level could be a powerful risk marker for eccentric left ventricular geometry remodeling and could be potentially used to risk-stratify PD patients.
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