Abstract | INTRODUCTION: METHODS: Data from participants of the CONvective TRAnsport Study who underwent serial transthoracic echocardiography were used. Based on left ventricular mass (LVM) and relative wall thickness (RWT), 4 types of left ventricular geometry were distinguished: normal, concentric remodeling, eLVH, and cLVH. Determinants of eLVH were assessed with logistic regression. Left ventricular geometry of patients who died and survived were compared. Long-term changes in RWT and LVM were evaluated with a linear mixed model. FINDINGS: Three hundred twenty-two patients (63.1 ± 13.3 years) were included. At baseline, LVH was present in 71% (cLVH: 27%; eLVH: 44%). Prior cardiovascular disease (CVD) was positively associated with eLVH and ß-blocker use inversely. None of the putative volume parameters showed any relationship with eLVH. Although eLVH was most prevalent in non-survivors, the distribution of left ventricular geometry did not vary over time. DISCUSSION: The finding that previous CVD was positively associated with eLVH may result from the permanent high cardiac output and the strong tendency for aortic valve calcification in this group of long-term hemodialysis patients, who suffer generally also from chronic anemia and various other metabolic derangements. No association was found between eLVH and parameters of fluid balance. The distribution of left ventricular geometry did not alter over time. The assumption that LV geometry worsens over time in susceptible individuals, who then suffer from a high risk of dying, may explain these findings.
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Authors | Menso J Nubé, Tiny Hoekstra, Volkan Doganer, Michiel L Bots, Peter J Blankestijn, Marinus van den Dorpel, Otto Kamp, Piet M Ter Wee, Camiel L M de Roij van Zuijdewijn, Muriel P C Grooteman |
Journal | Hemodialysis international. International Symposium on Home Hemodialysis
(Hemodial Int)
Vol. 22
Issue 3
Pg. 359-368
(07 2018)
ISSN: 1542-4758 [Electronic] Canada |
PMID | 29461006
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2018 The Authors Hemodialysis International published by Wiley Periodicals, Inc. on behalf of International Society for Hemodialysis. |
Topics |
- Female
- Humans
- Hypertrophy, Left Ventricular
(physiopathology)
- Kidney Failure, Chronic
(complications)
- Male
- Middle Aged
- Renal Dialysis
- Ventricular Remodeling
(physiology)
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