Prognostic significance of concentric left ventricular hypertrophy at peritoneal dialysis initiation
| Autor: | Misato Tomura, Haruki Kume, Kent Doi, Ryo Matsuura, Yohei Komaru, Masaomi Nangaku, Akihiko Matsumoto, Yoshihisa Miyamoto, Yoshifumi Hamasaki |
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| Rok vydání: | 2021 |
| Předmět: |
Life prognosis
Male Nephrology medicine.medical_specialty medicine.medical_treatment Peritoneal dialysis Serum albumin 030232 urology & nephrology 030204 cardiovascular system & hematology Left ventricular hypertrophy 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans Risk factor Dialysis Aged Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Proportional hazards model Concentric left ventricular hypertrophy Age Factors Retrospective cohort study Middle Aged Cardiovascular disease Prognosis medicine.disease Diseases of the genitourinary system. Urology Cardiovascular Diseases Echocardiography Cardiology Kidney Failure Chronic Female Hypertrophy Left Ventricular RC870-923 business Mace Research Article |
| Zdroj: | BMC Nephrology BMC Nephrology, Vol 22, Iss 1, Pp 1-11 (2021) |
| ISSN: | 1471-2369 |
| Popis: | BackgroundConcentric left ventricular hypertrophy (cLVH) is a common left ventricular geometric pattern in patients undergoing maintenance dialysis, including peritoneal dialysis (PD). The relationship between cLVH at PD initiation and the prognosis of patients remains unclear, however. This study aimed to investigate the impact of cLVH at PD initiation on patient survival and major adverse cardiovascular events (MACE).MethodsThe retrospective cohort study included 131 patients who underwent echocardiography during the PD initiation period. Based on echocardiographic measurements, cLVH was defined as a condition with increased LV mass index and increased relative wall thickness. The relationship between cLVH and the prognosis was assessed.ResultsConcentric LVH was identified in 29 patients (22%) at PD initiation, and patient survival, MACE-free survival and PD continuation were significantly reduced in the cLVH group compared with the non-cLVH group. In the Cox regression analysis, cLVH was demonstrated as an independent risk factor of mortality (HR [95%CI]: 3.32 [1.13–9.70]) for all patients. For patients over 65 years old, cLVH was significantly associated with mortality and MACE (HR [95%CI]: 3.51 [1.06–11.58] and 2.97 [1.26–7.01], respectively). Serum albumin at PD initiation was independently correlated with cLVH.ConclusionsIn our study, cLVH at PD initiation was independently associated with survival in all patients and with both survival and MACE in elderly patients. Evaluation of LV geometry at PD initiation might therefore help identify high-risk patients. Further studies involving larger numbers of patients are needed to confirm the findings from this study and clarify whether treatment interventions for factors such as nutrition status could ameliorate cLVH and improve patient outcomes. |
| Databáze: | OpenAIRE |
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