Related Experiment Video

Updated: Mar 31, 2026

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
06:34

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Published on: October 28, 2020

4.8K

Impact of Left Ventricular Geometry on All-Cause Mortality in Patients Undergoing Hemodialysis: A Longitudinal

Yoshihiro Nakamura1, Shimon Kurasawa1, Toru Kondo2

  • 1Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

Kidney360
|March 30, 2026
PubMed

Insights

Left ventricular geometry abnormalities, particularly concentric hypertrophy and remodeling, significantly increase mortality risk in hemodialysis patients. Echocardiography can help predict this risk.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Medical Imaging

Background:

  • Left ventricular (LV) geometry classification predicts mortality in hypertension but is inconclusive in hemodialysis patients.
  • LV geometry is categorized into four types based on LV mass index and relative wall thickness.
  • Understanding LV geometry is crucial for risk stratification in chronic kidney disease patients.

Purpose of the Study:

  • To evaluate the association between four categories of LV geometry and all-cause mortality in hemodialysis patients.
  • To determine if LV geometry classification improves mortality risk prediction beyond LV hypertrophy alone.
  • To assess the prevalence of different LV geometry patterns in this population.

Main Methods:

  • Retrospective multicenter cohort study in Japan (October 2006 - December 2021).
  • Included 2228 maintenance hemodialysis patients who underwent echocardiography.
  • Exposure: LV geometry abnormalities (concentric remodeling, eccentric hypertrophy, concentric hypertrophy). Outcome: All-cause death.

Main Results:

  • Nearly 80% of patients had abnormal LV geometry: concentric hypertrophy (30%) and concentric remodeling (27%) were most common.
  • Concentric hypertrophy (aHR 1.32) and concentric remodeling (aHR 1.27) were associated with significantly higher all-cause mortality risk compared to normal geometry.
  • Eccentric hypertrophy showed a similar mortality risk (aHR 1.03) to normal geometry.

Conclusions:

  • Abnormal LV geometry is highly prevalent in hemodialysis patients, with concentric hypertrophy and remodeling posing the greatest mortality risk.
  • Standard LV hypertrophy assessment misses the risk associated with concentric remodeling.
  • Echocardiography-based LV geometry assessment offers valuable risk prediction for hemodialysis patients.
Abstract

Keywords:
cardiovascular diseasedialysisechocardiographyhemodialysisleft ventricular hypertrophy

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