[Left ventricular hypertrophy in hemodialysis patient: Prevalence, electrocardiographic, echocardiographic study and associated risk factors].

Autor: Chargui S; Service de médecine interne A, hôpital Charles Nicolle, Tunis, Tunisie; Laboratoire de recherche de pathologie rénale (LR00SP01), Tunis, Tunisie. Electronic address: chargui.souma@yahoo.fr., Allouche E; Service de cardiologie, hôpital Charles Nicolle, Tunis, Tunisie., Dkhil W; Faculté de médecine de Tunis, Tunis, Tunisie., Agrebi S; Service de médecine interne A, hôpital Charles Nicolle, Tunis, Tunisie; Laboratoire de recherche de pathologie rénale (LR00SP01), Tunis, Tunisie., Ben Ahmed H; Service de cardiologie, hôpital Charles Nicolle, Tunis, Tunisie., Ezzaouia K; Service de cardiologie, hôpital Charles Nicolle, Tunis, Tunisie., Hajji M; Service de médecine interne A, hôpital Charles Nicolle, Tunis, Tunisie., Ezzamouri A; Service de médecine, hôpital régional de Djerba, Djerba, Tunisie., Basdah L; Service de cardiologie, hôpital Charles Nicolle, Tunis, Tunisie., Ben Hamida F; Laboratoire de recherche de pathologie rénale (LR00SP01), Tunis, Tunisie., Harzallah A; Service de médecine interne A, hôpital Charles Nicolle, Tunis, Tunisie; Laboratoire de recherche de pathologie rénale (LR00SP01), Tunis, Tunisie., Abderrahim E; Service de médecine interne A, hôpital Charles Nicolle, Tunis, Tunisie.
Jazyk: francouzština
Zdroj: Nephrologie & therapeutique [Nephrol Ther] 2022 Jul; Vol. 18 (4), pp. 247-254. Date of Electronic Publication: 2022 Jan 22.
DOI: 10.1016/j.nephro.2021.10.003
Abstrakt: Background: Left ventricular hypertrophy is the most prevalent cardiac abnormality in hemodialysis patients. The diagnosis of this abnormality is possible by electrocardiogram and/or echocardiography. Our study aimed to assess the prevalence of left ventricular hypertrophy in hemodialysis patients and the accuracy of different electrocardiographic criteria.
Methods: This was a cross-sectional retrospective study including 60 hemodialysis patients between 2017 and 2018. A left ventricular mass index higher than 115g/m 2  and 95g/m 2  respectively in men and women defines echocardiographic left ventricular hypertrophy. We assessed left ventricular hypertrophy prevalence, sensitivity, specificity, and area under the receiver-operating characteristics (ROC) curve of fourteen different electrocardiographic criteria for identification of left ventricular hypertrophy.
Results: This was a cohort of 60 patients composed of 27 men and 33 women with a mean age 52.6±15,8years. Hypertension was the most common cardiovascular risk factor (82 %). The prevalence of left ventricular hypertrophy at echography was 65 %. Prevalence of left ventricular hypertrophy at electrocardiographic varied across the different criteria ranging from 5 % (R wave in DI) to 32 % (Perugia score). The highest left ventricular hypertrophy prevalence at electrocardiographic was found with the five following criteria: Perugia score (32 %), Peguero-Lo Presti index (28 %), Sokolow-Lyon index, Cornell index, Framingham-adjusted Cornell voltage (17 %). Sensitivity was ranged from 5 % (R in DI, Gubner-Ungerleider index, and product) to 41 % (Perugia score). The specificity of most criteria was ≥90 % except for the Perugia score (85 %). The sensitivity, specificity, postitive and negative productive values and left ventricular hypertrophy prevalence using the five most accurate criteria combined were respectively 48, 90, 70.28, 77.85 and 33 %. Hypertension, duration of HD, arteriovenous fistula, interdialytic weight gain, systolic blood pressure, hemoglobin <9g/dL and hyperparathyroidism were significantly associated with left ventricular hypertrophy.
Conclusion: The prevalence of left ventricular hypertrophy detected by echocardiography was high. All electrocardiographic criteria had a low sensibility and a high specificity in the diagnostic of echocardiographic left ventricular hypertrophy. To improve the accuracy of electrocardiographic criteria, it is necessary to combine several electrocardiographic criteria and not often focused on a single classic electrocardiographic index.
(Copyright © 2021. Published by Elsevier Masson SAS.)
Databáze: MEDLINE
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