TY - JOUR
T1 - Left ventricular mass and hemodynamic overload in normotensive hemodialysis patients
AU - Lin, Yao Ping
AU - Chen, Chen Huan
AU - Yu, Wen Chung
AU - Hsu, Tsei Lieh
AU - Ding, Philip Yu An
AU - Yang, Wu Chang
N1 - Funding Information:
This work was supported in part by grants from the National Science Council (Grant No. NSC 88-2314-B-075-074 and NSC 89-2314-B-010-016), and the intramural grants from the Veterans General Hospital-Taipei, Taiwan, ROC (Grant No. VGH 87-306, VGH 88-304, and VGH 89-257). Part of this study was presented at the 33 rd Annual Meeting of American Society of Nephrology.
PY - 2002
Y1 - 2002
N2 - Background. It remains uncertain whether the hemodynamic parameters are important determinants of left ventricular mass (LVM) in normotensive chronic hemodialysis (NTHD) patients, as has been found in their hypertensive counterparts. Methods. Forty NTHD patients (mean age, 53.7 ± 14.4 years; male/female, 18/22) without the requirement of antihypertensive drugs for at least six months were studied. Controls were 41 hypertensive hemodialysis patients (HTHD) and 46 normotensive subjects with normal renal function (NTNR). The influence of anthropometrics, cardiovascular structure and function, and volume status on LVM (by two-dimensional echocardiography) was analyzed by steps of multiple linear regression. Results. As compared with the NTNR and NTHD group, the HTHD group had obvious pressure and volume/flow overload, and greater LV wall thickness, chamber size and mass. In contrast, NTHD subjects had similar blood pressure, large artery function, LV chamber size and stroke volume as the NTNR subjects. However, the NTHD patients still had greater wall thickness and LVM, along with greater cardiac output, lower total peripheral resistance and lower end-systolic meridional stress to volume ratio (ESSV) than the NTNR group. LVM in the NTHD group was significantly positively related to averaged systolic blood pressure (SBPavg), body surface area, extracellular fluid (ECF), carotid intima-media thickness (IMT), aortic pulse wave velocity (PWV), and negatively related to ESSV and Kt/V. The independent significant noncardiac structural determinants of LVM in NTHD subjects were ESSV, SBPavg, PWV and SV (model r2 = 0.617, P < 0.001). Conclusions. The NTHD patients, without significant pressure and volume overload, still had increased LVM that was partially explained by the persistent flow overload and subclinical LV dysfunction.
AB - Background. It remains uncertain whether the hemodynamic parameters are important determinants of left ventricular mass (LVM) in normotensive chronic hemodialysis (NTHD) patients, as has been found in their hypertensive counterparts. Methods. Forty NTHD patients (mean age, 53.7 ± 14.4 years; male/female, 18/22) without the requirement of antihypertensive drugs for at least six months were studied. Controls were 41 hypertensive hemodialysis patients (HTHD) and 46 normotensive subjects with normal renal function (NTNR). The influence of anthropometrics, cardiovascular structure and function, and volume status on LVM (by two-dimensional echocardiography) was analyzed by steps of multiple linear regression. Results. As compared with the NTNR and NTHD group, the HTHD group had obvious pressure and volume/flow overload, and greater LV wall thickness, chamber size and mass. In contrast, NTHD subjects had similar blood pressure, large artery function, LV chamber size and stroke volume as the NTNR subjects. However, the NTHD patients still had greater wall thickness and LVM, along with greater cardiac output, lower total peripheral resistance and lower end-systolic meridional stress to volume ratio (ESSV) than the NTNR group. LVM in the NTHD group was significantly positively related to averaged systolic blood pressure (SBPavg), body surface area, extracellular fluid (ECF), carotid intima-media thickness (IMT), aortic pulse wave velocity (PWV), and negatively related to ESSV and Kt/V. The independent significant noncardiac structural determinants of LVM in NTHD subjects were ESSV, SBPavg, PWV and SV (model r2 = 0.617, P < 0.001). Conclusions. The NTHD patients, without significant pressure and volume overload, still had increased LVM that was partially explained by the persistent flow overload and subclinical LV dysfunction.
KW - Blood pressure
KW - Cardiac load
KW - Dry weight
KW - End-stage renal disease
KW - Hemodialysis
KW - Two-dimensional echocardiogram
KW - Vascular load
UR - http://www.scopus.com/inward/record.url?scp=0036408423&partnerID=8YFLogxK
U2 - 10.1046/j.1523-1755.2002.00610.x
DO - 10.1046/j.1523-1755.2002.00610.x
M3 - Article
C2 - 12371986
AN - SCOPUS:0036408423
SN - 0085-2538
VL - 62
SP - 1828
EP - 1838
JO - Kidney International
JF - Kidney International
IS - 5
ER -