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Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
Left ventricular hypertrophy and left atrial diameter are associated with mortality risk in haemodialysis patients: a
Jiuxu Bai1, Wanqing Huang1,2, Yanping Zhang1
1Department of Blood Purification, General Hospital of Northern Theater Command, 83 Wen Hua Road, Shenyang, 110016, Liaoning, China.
Insights
In end-stage kidney disease patients on hemodialysis, enlarged left atrial diameter (LAD) significantly increases mortality risk. Combined high LAD and left ventricular hypertrophy (LVH) further elevates risks, aiding in patient mortality stratification.
Area of Science:
- Nephrology
- Cardiology
- Clinical Medicine
Background:
- Cardiovascular disease is the leading cause of death in end-stage kidney disease (ESKD) patients.
- Left ventricular hypertrophy (LVH) and left atrial diameter (LAD) enlargement are common in ESKD and are significant risk factors for cardiovascular events.
Purpose of the Study:
- To investigate the association between combined left atrial diameter (LAD) and left ventricular hypertrophy (LVH) and mortality in end-stage kidney disease (ESKD) patients.
- To determine if LAD or LVH alone or in combination impacts all-cause or cardiovascular mortality.
Main Methods:
- A retrospective cohort study of 576 hemodialysis (HD) patients.
- Patients were categorized into four groups based on LAD and LVH status.
- Kaplan-Meier analysis and Cox regression were used to assess mortality risks.
Main Results:
- Enlarged left atrial diameter (LAD) was significantly associated with increased all-cause mortality (HR 2.371).
- Left ventricular hypertrophy (LVH) alone did not show a significant association with all-cause mortality.
- Patients with both high LAD and LVH exhibited significantly higher all-cause and cardiovascular mortality compared to those with low LAD and no LVH.
Conclusions:
- Left atrial diameter (LAD) is a stronger predictor of mortality than left ventricular hypertrophy (LVH) in maintenance hemodialysis (MHD) patients.
- The combination of high LAD and LVH significantly increases mortality risk.
- Assessing combined LAD and LVH aids in stratifying mortality risk for MHD patients.
Background:
Cardiovascular death is the main cause of death in patients with end-stage kidney disease (ESKD). Left ventricular hypertrophy (LVH) and left atrial diameter (LAD) enlargement are frequent cardiac alterations in patients with ESKD and are major risk factors for cardiovascular events. However, it remains unclear whether there is an association between combined LAD or LVH and all-cause or cardiovascular mortality in this population.
Methods:
A single-centre, retrospective cohort study including 576 haemodialysis (HD) patients was conducted. Patients were evaluated by cardiac ultrasound, and the study cohort was divided into four groups according to LAD and LVH status: low LAD and non-LVH; low LAD and LVH; high LAD and non-LVH; and high LAD and LVH. We used Kaplan-Meier analysis and Cox proportional hazard regression to analyse all-cause and cardiovascular mortality after multivariate adjustment.
Results:
LAD was associated with an increased risk of all-cause mortality (HR 2.371, 1.602-3.509; p < 0.001). No significant differences were found between LVH and the risk of all-cause mortality. Patients with high LAD and LVH had significantly greater all-cause and cardiovascular mortality than did those with low LAD and non-LVH after adjustments for numerous potential confounders (HR 3.080, 1.608-5.899; p = 0.001) (HR 4.059, 1.753-9.397; p = 0.001).
Conclusion:
Among maintenance haemodialysis (MHD) patients, LAD was more strongly associated with mortality than was LVH. A high LAD and LVH are associated with a greater risk of mortality. Our results emphasize that the occurrence of LAD and LVH in combination provides information that may be helpful in stratifying the risk of MHD patients.
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