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Correlates of left ventricular mass in chronic hemodialysis recipients.

Publication ,  Journal Article
Wald, R; Goldstein, MB; Wald, RM; Harel, Z; Kirpalani, A; Perl, J; Yuen, DA; Wolf, MS; Yan, AT
Published in: Int J Cardiovasc Imaging
February 2014

We aimed to clarify the correlates of left ventricular mass and secondarily, left ventricular volume, in a cohort of prevalent hemodialysis recipients. Left ventricular hypertrophy is common and left ventricular mass is a widely-accepted surrogate for clinical outcomes in dialysis recipients, who are often subjected to chronic pressure and volume overload. However, the precise pathophysiologic mechanisms of left ventricular hypertrophy in this unique population have not been well understood. This was a cross-sectional study of patients receiving conventional thrice-weekly dialysis in Toronto, Canada. Left ventricular mass and volume were assessed with cardiac magnetic resonance and indexed to the patient's height to the power of 2.7. Fibroblast growth factor-23 concentration was measured using a C-terminal enzyme-linked immunosorbent assay. Patient demographics, comorbidities, dialysis-associated blood pressures and ultrafiltration volumes, biochemical and hematologic parameters, vascular access and medications were extracted from clinical records. Multivariable linear regression was used to identify independent correlates of left ventricular mass index (LVMI) and the left ventricular end diastolic volume index (LVEDVI). We enrolled 56 patients, of whom 23 (41.1 %) were women with mean age 54 ± 12 years. Mean LVMI was 31.1 ± 6.8 g/m(2.7). In multivariable analyses, systolic blood pressure and LVEDVI were the only factors significantly associated with LVMI. Post-dialysis weight, percent reduction in urea and the presence of a permanent form of vascular access were associated with LVEDVI. Fibroblast growth factor-23 was not associated with either LVMI or LVEDVI. Blood pressure and left ventricular dilatation are independent determinants of elevated left ventricular mass. Aggressive blood pressure reduction and avoidance of volume overload may confer LVM regression and improve clinical outcomes.

Duke Scholars

Published In

Int J Cardiovasc Imaging

DOI

EISSN

1875-8312

Publication Date

February 2014

Volume

30

Issue

2

Start / End Page

349 / 356

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Renal Insufficiency, Chronic
  • Renal Dialysis
  • Prospective Studies
  • Predictive Value of Tests
  • Ontario
  • Odds Ratio
  • Nuclear Medicine & Medical Imaging
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wald, R., Goldstein, M. B., Wald, R. M., Harel, Z., Kirpalani, A., Perl, J., … Yan, A. T. (2014). Correlates of left ventricular mass in chronic hemodialysis recipients. Int J Cardiovasc Imaging, 30(2), 349–356. https://doi.org/10.1007/s10554-013-0337-0
Wald, Ron, Marc B. Goldstein, Rachel M. Wald, Ziv Harel, Anish Kirpalani, Jeffrey Perl, Darren A. Yuen, Myles S. Wolf, and Andrew T. Yan. “Correlates of left ventricular mass in chronic hemodialysis recipients.Int J Cardiovasc Imaging 30, no. 2 (February 2014): 349–56. https://doi.org/10.1007/s10554-013-0337-0.
Wald R, Goldstein MB, Wald RM, Harel Z, Kirpalani A, Perl J, et al. Correlates of left ventricular mass in chronic hemodialysis recipients. Int J Cardiovasc Imaging. 2014 Feb;30(2):349–56.
Wald, Ron, et al. “Correlates of left ventricular mass in chronic hemodialysis recipients.Int J Cardiovasc Imaging, vol. 30, no. 2, Feb. 2014, pp. 349–56. Pubmed, doi:10.1007/s10554-013-0337-0.
Wald R, Goldstein MB, Wald RM, Harel Z, Kirpalani A, Perl J, Yuen DA, Wolf MS, Yan AT. Correlates of left ventricular mass in chronic hemodialysis recipients. Int J Cardiovasc Imaging. 2014 Feb;30(2):349–356.

Published In

Int J Cardiovasc Imaging

DOI

EISSN

1875-8312

Publication Date

February 2014

Volume

30

Issue

2

Start / End Page

349 / 356

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Renal Insufficiency, Chronic
  • Renal Dialysis
  • Prospective Studies
  • Predictive Value of Tests
  • Ontario
  • Odds Ratio
  • Nuclear Medicine & Medical Imaging