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Prevalence and patterns of left ventricular hypertrophy in patients with predialysis chronic renal failure
1Department of Internal Medicine, Yongdong Severance Hospital, Institute of Kidney Disease, Yonsei University, College of Medicine, Seoul, Korea. hask1951@yumc.yonsei.ac.kr
Insights
Left ventricular hypertrophy (LVH) affects 87% of predialysis chronic renal failure (CRF) patients, with concentric hypertrophy being most common. Factors like blood pressure, anemia, and PTH significantly influence LVH in CRF.
Area of Science:
- Cardiology
- Nephrology
- Medical Research
Background:
- Left ventricular hypertrophy (LVH) is a significant risk factor for cardiac mortality.
- Chronic renal failure (CRF) is associated with increased cardiovascular risks.
- Understanding LVH prevalence and patterns in predialysis CRF is crucial for risk stratification.
Purpose of the Study:
- To determine the prevalence and patterns of LVH in patients with predialysis CRF.
- To analyze the relationship between LVH and predisposing factors in this population.
Main Methods:
- Echocardiography was used to measure left ventricular mass index (LVMI) and relative wall thickness (RWT) in 62 predialysis CRF patients (serum creatinine > 2 mg/dl).
- Patients were categorized into four groups based on LVMI and RWT: normal, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy.
- Statistical analyses explored correlations between LVMI and clinical parameters including blood pressure, serum creatinine, creatinine clearance, hemoglobin, and intact parathyroid hormone.
Main Results:
- A high prevalence of LVH (87%) was observed in predialysis CRF patients.
- Concentric hypertrophy was the predominant pattern, identified in 56.5% of patients.
- LVMI showed significant linear correlations with systolic and diastolic blood pressure, serum creatinine, and intact parathyroid hormone.
- Inverse linear correlations were found between LVMI and creatinine clearance and hemoglobin levels.
- LVMI increased with declining renal function.
Conclusions:
- Predialysis CRF is associated with a high prevalence of LVH, primarily concentric hypertrophy.
- Factors including anemia, hypertension, impaired renal function, and elevated parathyroid hormone levels contribute to LVH in CRF patients.
- These findings highlight the need for early detection and management of LVH in CRF to mitigate cardiac risks.
Abstract:
Left ventricular hypertrophy (LVH) is an independent risk factor for cardiac death. This study evaluates the prevalence and patterns of LVH in patients with predialysis chronic renal failure (CRF) and analyses the relationship between LVH and various predisposing factors. Sixty-two CRF patients were recruited from the renal clinic with serum creatinine over 2 mg/dl. Using echocardiography, we calculated the left ventricular mass index (LVMI) and relative wall thickness (RWT), and classified the patients into four groups (Group 1: normal, Group 2: concentric remodelling, Group 3: concentric hypertrophy, Group 4: eccentric hypertrophy). Prevalence and patterns of LVH in patients with CRF were as follows; 6.5% in Groups 1 and 2, 56.5% in Group 3 and 30.5% in Group 4. LVMI increases with progressive renal function decline. There were linear correlations between LVMI and systolic and diastolic blood pressure (BP), serum creatinine (Scr) and intact parathyroid hormone (PTH) in patients with predialysis CRF and also inverse linear correlations between LVMI and creatinine clearance (Ccr) and hemoglobin. In conclusion, we demonstrate the high prevalence of LVH (87%) in patients with predialysis CRF and concentric hypertrophy (56.5%) was the main pattern of LVH. Several factors such as anemia, systolic and diastolic BP, renal function and PTH influence LVMI.