TY - JOUR
T1 - Impact of definitions of left ventricular hypertrophy on left ventricular remodeling findings in patients with predialysis chronic kidney disease
T2 - An echocardiographic study
AU - Chen, Shih Jen
AU - Liu, Ping Chang
AU - Yang, Ning I.
AU - Cheng, Chi Wen
AU - Wu, I. Wen
AU - Wu, Mai Szu
AU - Cherng, Wen Jin
AU - Hung, Ming Jui
PY - 2012/3
Y1 - 2012/3
N2 - Background: The impact of different definitions of left ventricular hypertrophy (LVH) on the assessment of left ventricular (LV) remodeling in predialysis chronic kidney disease (CKD) remains unclear. Methods: Echocardiography was performed on 107 consecutively enrolled patients with different stages of CKD including 36 patients mild CKD (CKD stages 1 and 2) and 71 patients with moderate/severe CKD (CKD stages 3, 4, and 5). LVH was defined by the following three sets of sex-specific criteria: left ventricular mass (LVM) indexed to body surface area; LVM indexed to height; and LVM indexed to height 2.7. Results: In the mild CKD group, LVMindexed to height 2.7 detected 14 in 15 LVH patients; however, LVM indexed to BSA and height detected 9 and 7 patients, respectively. In the moderate/severe CKD group, LVM indexed to height 2.7 detected 42 in 43 LVH patients; however, LVM indexed to BSA and height both detected 29 patients. In the moderate/severe CKD group, patients with LVH who fulfilled all three criteria at the same time had lower Em and Am and higher mitral E/Em and isovolumic relaxation time (IVRT) than those patients without LVH. Among patients without LVH, moderate/severe CKD patients had significantly higher mitral E/Em and longer IVRT than in mild CKD. In multivariable regression analysis, the independent predictors of septal E/Em > 15 were CKD severity (odds ratio = 3.16, 95% confidence interval = 1.64-6.08, p = 0.001) and LVH indexed by height 2.7 (odds ratio = 4.10, 95% confidence interval = 1.27-13.32, p = 0.019). Conclusion: LVH indexed by height 2.7 could detect most of the LVH in predialysis CKD patients.
AB - Background: The impact of different definitions of left ventricular hypertrophy (LVH) on the assessment of left ventricular (LV) remodeling in predialysis chronic kidney disease (CKD) remains unclear. Methods: Echocardiography was performed on 107 consecutively enrolled patients with different stages of CKD including 36 patients mild CKD (CKD stages 1 and 2) and 71 patients with moderate/severe CKD (CKD stages 3, 4, and 5). LVH was defined by the following three sets of sex-specific criteria: left ventricular mass (LVM) indexed to body surface area; LVM indexed to height; and LVM indexed to height 2.7. Results: In the mild CKD group, LVMindexed to height 2.7 detected 14 in 15 LVH patients; however, LVM indexed to BSA and height detected 9 and 7 patients, respectively. In the moderate/severe CKD group, LVM indexed to height 2.7 detected 42 in 43 LVH patients; however, LVM indexed to BSA and height both detected 29 patients. In the moderate/severe CKD group, patients with LVH who fulfilled all three criteria at the same time had lower Em and Am and higher mitral E/Em and isovolumic relaxation time (IVRT) than those patients without LVH. Among patients without LVH, moderate/severe CKD patients had significantly higher mitral E/Em and longer IVRT than in mild CKD. In multivariable regression analysis, the independent predictors of septal E/Em > 15 were CKD severity (odds ratio = 3.16, 95% confidence interval = 1.64-6.08, p = 0.001) and LVH indexed by height 2.7 (odds ratio = 4.10, 95% confidence interval = 1.27-13.32, p = 0.019). Conclusion: LVH indexed by height 2.7 could detect most of the LVH in predialysis CKD patients.
KW - Echocardiography
KW - Kidney
KW - Left ventricular hypertrophy
KW - Remodeling
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M3 - Article
AN - SCOPUS:84865527369
VL - 28
SP - 42
EP - 52
JO - Acta Cardiologica Sinica
JF - Acta Cardiologica Sinica
SN - 1011-6842
IS - 1
ER -