Russian Heart Failure Journal 2009year Left ventricular myocardial hypertrophy and its predictive significance in patients with CRD

To access this material please log in or register

Register Authorize

Left ventricular myocardial hypertrophy and its predictive significance in patients with CRD

Gendlin G. E., Shilo V. Yu., Tomilina N. A., Storozhakov G. I., Borisovskaya S. V., Ettinger O. A., Badaeva S. V., Gavryushina O. A.



Urgency. A tight association between left ventricular hypertrophy (LVH) and death rate including death from cardiovascular complications has been demonstrated in the population of patients receiving the programmed hemodialysis treatment (PHD). Aim. Evaluating the prognostic significance of LVH in patients treated with programmed hemodialysis. Materials and methods. We have observed 212 patients receiving the PHD treatment. EchoCG was performed in 185 patients (89 women and 96 men; median age, 50 years) at the study onset. Among other echoCG parameters, the LV myocardial mass index (MMI) was calculated, and the ejection fraction was measured. Pulse wave velocity (PWV) was measured in the aorta. Biochemical and clinical blood tests were performed. A 2-day study of BP dynamics was performed in 86 patients (43 men and 43 women) in the interdialysis period. In addition, 78 patients (31 men and 47 women younger than 55 years) with predialysis renal insufficiency were examined as a reference group, in accordance with the same schedule. Results. It was shown that LVH determined survival of patients receiving the replacement renal therapy with PHD, especially in the female population. Death of the evaluated women was caused by conditions associated with LVH, primarily heart failure. Death of female patients with predialysis chronic renal disease receiving the PHD treatment was caused by a combination of high BP and some uremia factors, correction of which may improve survival of such patients.
  1. Kannel WB, Gordon T, Offutt D. Left ventricular hypertrophy by electrocardiogram: prevalence, incidence and mortality in the Framingham Study. Ann Intern Med. 1969; 71 (1):89‑105.
  2. Sheridan DJ. Left Ventricular Hypertrophy. – Churchill Livingstone, 1998. – 209 p.
  3. Levy D, Garrison RJ, Savage DD et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med. 1990; 322 (22):1561–1566.
  4. Koren M, Devereux R, Casale P. Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med. 1991; 114 (5):345‑352.
  5. Verdecchia P, Shillaci G, Borgioni C et al. Prognostic significance of serial changes in left ventricular mass in essential hypertension. Circulation. 1998; 97 (1):48–54.
  6. Verdecchia P, Carini G, Circo A et al. Left ventricular mass and cardiovascular morbidity in essential hypertension: the MAVI study. J Am Coll Cardiol. 2001; 38 (7):1829–1835.
  7. Gueyffier F, Bulpitt C, Boissel JP et al. Antihypertensive drugs in very old people: a subgroup meta-analysis of randomized controlled trials. Lancet. 1999; 353 (9155):793‑796.
  8. Vakili BA, Okin PM, Devereux RB. Prognostic implications of left ventricular hypertrophy. Am Heart J. 2001; 141 (3):334‑341.
  9. Foley RN, Parfrey PS, Harnett JD et al. The prognostic importance of left ventricular geometry in uremic cardiomyopathy. J Am Soc Nephrol. 1995; 5 (12):2024–2031.
  10. Stack AG, Saran R. Clinical correlates and mortality impact of left ventricular hypertrophy among new ESRD patients in the United States. Am J Kidney Dis. 2002; 40 (6):1202–1210.
  11. Paoletti E, Specchia C, Di Maio G et al. The worsening of left ventricular hypertrophy is the strongest predictor of sudden cardiac death in haemodialysis patients: a 10 year survey. Nephrol Dial Transplant. 2004; 19 (7):1829–1834.
  12. Zoccali C, Benedetto FA, Mallamaci F et al. Left ventricular mass monitoring in the follow-up of dialysis patients: Prognostic value of left ventricular hypertrophy progression. Kidney Int. 2004; 65 (4):1492–1498.
  13. Kessler M, Zannad M, Lehert P et al. Predictors of cardiovascular events in patients with end-stage renal disease: an analysis from the Fosinopril in Dialysis study. Nephrol Dial Transplant. 2007; 22 (12):3573–3579.
  14. Weiner DE, Tighiouart H, Vlagopoulos PT et al. Effects of anemia and left ventricular hypertrophy on cardiovascular disease in patients with chronic kidney disease. J Am Soc Nephrol. 2005; 16 (6):1803–1810.
  15. Paoletti E, Cannella G. Left ventricular hypertrophy in chronic kidney disease. G Ital Nefrol. 2006; 23 (6):560‑568.
  16. Перекокин Ю. Н., Шило В. Ю., Гендлин Г. Е. и др. Скорость пульсовой волны и податливость аорты у больных на программном гемодиализе: связь с факторами риска, кальцинозом сердца и показателями внутрисердечной гемодинамики. Нефрология и диализ. 2004; 6 (1):62–69.
  17. Секция артериальной гипертонии ВНОК. Профилактика, диагностика и лечение артериальной гипертензии. Российские рекомендации (второй пересмотр). http: / doc / pdf / ah.pdf
  18. London GM, Pannier B, Guerin AP et al. Alterations of left ventricular hypertrophy in and survival of patients receiving hemodialysis: follow-up of an interventional study. J Am Soc Nephrol. 2001; 12 (12):2759–2767.
  19. Zannad F, Kessler M, Grünfeld JP et al. FOSIDIAL: a randomised placebo controlled trial of the effects of fosinopril on cardiovascular morbidity and mortality in haemodialysis patients. Study design and patients’ baseline characteristics. Fundam Clin Pharmacol. 2002; 16 (5):353‑360.
  20. Coletta AP, Cleland JG, Freemantle N, Clark AL. Clinical trials update from the European Society of Cardiology Heart Failure meeting: SHAPE, BRING-UP 2 VAS, COLA II, FOSIDIAL, BETACAR, CASINO and meta-analysis of cardiac resynchronisation therapy. Eur J Heart Fail. 2004; 6 (5):673‑676.

To access this material please log in or register

Register Authorize
Ru En