Changes in Left Ventricular Anatomy and Function on CAPD

1983 ◽  
Vol 3 (3_suppl) ◽  
pp. 26-28 ◽  
Author(s):  
Frans H.H. Leenen ◽  
Donna L. Smith ◽  
Ramesh Khanna ◽  
Dimitrios G. Oreopoulos
Keyword(s):  
Volume Overload ◽  
Left Ventricular ◽  
Lv Function ◽  
Lv Mass ◽  
Consistent Manner ◽  
Eccentric Hypertrophy ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Function

In 17 patients with end-stage renal disease, we evaluated the effects of treatment with CAPD on L V anatomy and function by M -mode echocardiography. All patients had a history of hypertension and had echocardiographic evidence of increased LV mass related to both concentric and eccentric hypertrophy. On CAPD, blood pressure returned to normal in a consistent manner. L V mass decreased in most (14/17) patients as a result of a decrease in both L V wall thickness and LV dimension. Initially four of the 17 patients had diminished LV function. On CAPD, LV function improved in three of these four and no patient showed deterioration. These results indicate that CAPD improves L V hypertrophy and L V function by normalizing both pressure and volume overload.

scholarly journals Alterations of Left Ventricular Hypertrophy in and Survival of Patients Receiving Hemodialysis: Follow-up of an Interventional Study

2001 ◽  
Vol 12 (12) ◽  
pp. 2759-2767 ◽  
Author(s):  
Gérard M. London ◽  
Bruno Pannier ◽  
Alain P. Guerin ◽  
Jacques Blacher ◽  
Sylvain J. Marchais ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Left Ventricular ◽  
Independent Effect ◽  
Lv Mass ◽  
History Of ◽  
Cv Disease ◽  
Stage Renal Disease ◽  
End Stage

ABSTRACT. Left ventricular (LV) hypertrophy (LVH) is a risk factor for mortality in patients with end-stage renal disease (ESRD). Whether the attenuation of LVH has a positive effect on survival of patients with ESRD has not been documented. The aim of this study was to determine the effect of parallel treatment of hypertension and anemia on LV mass (LVM) and to determine the effect of LVM changes on survival. A cohort of 153 patients receiving hemodialysis was studied. The duration of follow-up was 54 ± 37 mo. All patients had echocardiographic determination of LV dimensions and LVM at baseline and regular intervals until the end of the follow-up period. During the study, BP decreased from (mean ± SD) 169.4 ± 29.7/90.2 ± 15.6 to 146.7 ± 29/78 ± 14.1 mmHg (P< 0.001), and hemoglobin increased from 8.65 ± 1.65 to 10.5 ± 1.45 g/dl (P< 0.001). The LV end-diastolic diameter and mean wall thickness decreased from 56.6 ± 6.5 to 54.8 ± 6.5 mm (P< 0.001), and from 10.4 ± 1.6 to 10.2 ± 1.6 mm (P< 0.05), respectively. The LVM decreased from 290 ± 80 to 264 ± 86 g (P< 0.01). Fifty-eight deaths occurred, 38 attributed to cardiovascular (CV) disease and 20 attributed to non-CV causes. According to Cox analyses after adjustment for age, gender, diabetes, history of CV disease, and all nonspecific CV risk factors, LVM regression positively affected the survival. The hazard risk ratio associated with a 10% LVM decrease was 0.78 (95% confidence interval, 0.63 to 0.92) for all-causes mortality and 0.72 (95% confidence interval, 0.51 to 0.90) for mortality due to CV disease. These results show that a partial LVH regression in patients with ESRD had a favorable and independent effect on patients’ all-cause and CV survival.

scholarly journals Left ventricular mass and myocardial scarring in women with hypertensive disorders of pregnancy

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001273
Author(s):  
Odayme Quesada ◽  
Ki Park ◽  
Janet Wei ◽  
Eileen Handberg ◽  
Chrisandra Shufelt ◽  
...  
Keyword(s):  
Vascular Dysfunction ◽  
Obstructive Coronary Artery Disease ◽  
Left Ventricular ◽  
Hypertensive Disorders Of Pregnancy ◽  
Similar Frequency ◽  
Hypertensive Disorders ◽  
Lv Mass ◽  
Scar Size ◽  
History Of ◽  
And Function

AimsHypertensive disorders of pregnancy (HDP) predict future cardiovascular events. We aim to investigate relations between HDP history and subsequent hypertension (HTN), myocardial structure and function, and late gadolinium enhancement (LGE) scar.Methods and resultsWe evaluated a prospective cohort of women with suspected ischaemia with no obstructive coronary artery disease (INOCA) who underwent stress/rest cardiac magnetic resonance imaging (cMRI) with LGE in the Women’s Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction study. Self-reported history of pregnancy and HDP (gestational HTN, pre-eclampsia, toxaemia and eclampsia) were collected at enrollment. In our cohort of 346, 20% of women report a history of HDP. HDP history was associated with 3.2-fold increased odds of HTN. Women with a history of both HDP and HTN had higher cMRI measured left ventricular (LV) mass compared with women with HDP only (99.4±2.6 g vs 87.7±3.2 g, p=0.02). While we found a similar frequency of LGE scar, we observed a trend towards increased LGE scar size (5.1±3.4 g vs 8.0±3.4 g, p=0.09) among the women with HDP history compared to women without.ConclusionIn a high-risk cohort of women with suspected INOCA, 20% had a history of HDP. Women with HDP history were more likely to develop HTN. Our study demonstrates higher LV mass in women with HDP and concomitant HTN. Although the presence of LGE scar was not different in women with and without HDP history, we observed a trend towards larger scar size in women with HDP. Future studies are needed to better assess the relationship of HDP and cardiac morphology and LGE scarring in a larger cohort of women.

scholarly journals Serum Aldosterone Is Related to Left Ventricular Geometry and Function in Young Adults with Never-Treated Primary Hypertension

2019 ◽  
Vol 8 (7) ◽  
pp. 1045 ◽  
Author(s):  
Seong-Mi Park ◽  
Mi-Na Kim ◽  
Sua Kim ◽  
Wan-Joo Shim
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Left Ventricular ◽  
Primary Hypertension ◽  
Lv Function ◽  
Amino Terminal ◽  
Serum Aldosterone ◽  
Lv Mass ◽  
And Function ◽  
Normal Controls

Background: Although aldosterone has been demonstrated to induce left ventricular (LV) hypertrophy not only in primary aldosteronism but also in primary hypertension (HT), it can be affected by multiple factors, including age, and the effect of aldosterone on LV function is controversial. This study was to investigate the relationship of aldosterone to changes in LV geometry and function in young adults with never-treated HT. Methods: Seventy-five consecutive patients (age, 29.8 ± 6.3 years) with never-treated HT and 45 normal controls were enrolled. Echocardiographic values and LV global longitudinal strain (LVGLS) were obtained. Serum aldosterone concentration (SAC) and serum procollagen type III amino-terminal peptide (PIIINP) level were obtained in HT patients. Results: HT patients had higher LV mass index, higher relative wall thickness (RWT), and worse LV function than normal controls. LVGLS and e’ velocity were worse in HT patients with normal geometry than in normal controls. SAC was well correlated with LV mass index, RWT, e’ velocity, LVGLS, and PIIINP (all p < 0.05). LV geometry pattern was most related to SAC among clinical parameters (p = 0.019). LVGLS was most related to LV geometry and diastolic blood pressure. In contrast, e’ velocity was most related to PIIINP. Conclusion: Our findings may indicate that in young patients with never-treated HT, aldosterone significantly contributes to changes in LV geometry and functional impairment through its pro-hypertrophic and myocardial fibrosis effects beyond blood pressure.

scholarly journals Podocytes—The Most Vulnerable Renal Cells in Preeclampsia

2020 ◽  
Vol 21 (14) ◽  
pp. 5051
Author(s):  
Ewa Kwiatkowska ◽  
Katarzyna Stefańska ◽  
Maciej Zieliński ◽  
Justyna Sakowska ◽  
Martyna Jankowiak ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Damage Mechanism ◽  
Endothelial Damage ◽  
Main Role ◽  
Long Time ◽  
National Cohort ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Function

Preeclampsia (PE) is a disorder that affects 3–5% of normal pregnancies. It was believed for a long time that the kidney, similarly to all vessels in the whole system, only sustained endothelial damage. The current knowledge gives rise to a presumption that the main role in the development of proteinuria is played by damage to the podocytes and their slit diaphragm. The podocyte damage mechanism in preeclampsia is connected to free VEGF and nitric oxide (NO) deficiency, and an increased concentration of endothelin-1 and oxidative stress. From national cohort studies, we know that women who had preeclampsia in at least one pregnancy carried five times the risk of developing end-stage renal disease (ESRD) when compared to women with physiological pregnancies. The focal segmental glomerulosclerosis (FSGS) is the dominant histopathological lesion in women with a history of PE. The kidney’s podocytes are not subject to replacement or proliferation. Podocyte depletion exceeding 20% resulted in FSGS, which is a reason for the later development of ESRD. In this review, we present the mechanism of kidney (especially podocytes) injury in preeclampsia. We try to explain how this damage affects further changes in the morphology and function of the kidneys after pregnancy.

scholarly journals Cardiac-restricted overexpression or deletion of tissue inhibitor of matrix metalloproteinase-4: differential effects on left ventricular structure and function following pressure overload-induced hypertrophy

2014 ◽  
Vol 307 (5) ◽  
pp. H752-H761 ◽  
Author(s):  
William M. Yarbrough ◽  
Catalin Baicu ◽  
Rupak Mukherjee ◽  
An Van Laer ◽  
William T. Rivers ◽  
...  
Keyword(s):  
Pressure Overload ◽  
Left Ventricular ◽  
Lv Function ◽  
Type I ◽  
Matrix Remodeling ◽  
Protective Effects ◽  
Ecm Remodeling ◽  
Hypertrophic Response ◽  
Lv Mass ◽  
And Function

Historically, the tissue inhibitors of matrix metalloproteinases (TIMPs) were considered monochromatic in function. However, differential TIMP profiles more recently observed with left ventricular (LV) dysfunction and matrix remodeling suggest more diverse biological roles for individual TIMPs. This study tested the hypothesis that cardiac-specific overexpression (TIMP-4OE) or deletion (knockout; TIMP-4KO) would differentially affect LV function and structure following pressure overload (LVPO). LVPO (transverse aortic constriction) was induced in mice (3.5 ± 0.1 mo of age, equal sex distribution) with TIMP-4OE ( n = 38), TIMP-4KO ( n = 24), as well as age/strain-matched wild type (WT, n = 25), whereby indexes of LV remodeling and function such as LV mass and ejection fraction (LVEF) were determined at 28 days following LVPO. Following LVPO, both early (7 days) and late (28 days) survival was ∼25% lower in the TIMP-4KO group ( P < 0.05). While LVPO increased LV mass in all groups, the relative hypertrophic response was attenuated with TIMP-4OE. With LVPO, LVEF was similar between WT and TIMP-4KO (48 ± 2% and 45 ± 3%, respectively) but was higher with TIMP-4OE (57 ± 2%, P < 0.05). With LVPO, LV myocardial collagen expression (type I, III) increased by threefold in all groups ( P < 0.05), but surprisingly this response was most robust in the TIMP-4KO group. These unique findings suggest that increased myocardial TIMP-4 in the context of a LVPO stimulus may actually provide protective effects with respect to survival, LV function, and extracellular matrix (ECM) remodeling. These findings challenge the canonical belief that increased levels of specific myocardial TIMPs, such as TIMP-4 in and of themselves, contribute to adverse ECM accumulation following a pathological stimulus, such as LVPO.

Abstract 05: Longer Duration of Obesity Beginning in Young Adulthood is Associated with Greater Left Ventricular Mass and Worse Left Ventricular Function in Middle-Age: The CARDIA Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Jared P Reis ◽  
Norrina B Allen ◽  
Bethany Barone-Gibbs ◽  
Joyce M Lee ◽  
Cora E Lewis ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Young Adulthood ◽  
Middle Age ◽  
Left Ventricular ◽  
Lv Function ◽  
Obesity Epidemic ◽  
Lv Mass ◽  
Table Model ◽  
And Function

Background: As a result of the obesity epidemic, individuals are becoming obese at a younger age than in previous generations. Yet, few studies have determined the consequences of a longer duration of obesity. The present study examined whether the duration of obesity beginning early in adulthood is associated with left ventricular (LV) structure and function in middle-age. Methods: We studied 2,545 white and black adults aged 18-30 years without obesity [body mass index (BMI) <30 kg/m 2 ] at baseline in 1985-86 or clinically apparent heart disease through year 25 (2010-11) in the multicenter, community-based CARDIA study. Duration of obesity (years with BMI ≥30.0 kg/m 2 ) was calculated using repeat measurements of BMI performed 2, 5, 7, 10, 15, 20, and 25 years after baseline. Outcomes included LV mass and ejection fraction from an echocardiogram performed during the 25-year follow-up examination. Results: During follow-up, 994 participants became obese (39.1%); mean duration of obesity was 14.1 years. After adjustment for demographic and behavioral covariates, including year 25 BMI, a longer duration of obesity was associated with a greater LV mass and a lower ejection fraction (Table, model 1). Further adjustment for intermediate clinical covariates, including antihypertensive medication use, systolic blood pressure, heart rate, and diabetes only modestly attenuated these associations (Table, model 2). These associations were similar across white and black men and women (p-interaction>0.10, for all). Conclusions: Longer duration of obesity from young adulthood to middle-age was associated with significantly greater LV mass and marginally lower LV function in midlife, independent of concurrent BMI.

Aging and Left Ventricular Mass and Function in People with End-Stage Renal Disease

2011 ◽  
Vol 59 (9) ◽  
pp. 1636-1641 ◽  
Author(s):  
Giovanni Tripepi ◽  
Francesco Mattace-Raso ◽  
Eric Sijbrands ◽  
Jacqueline Witteman ◽  
Francesco Rapisarda ◽  
...  
Keyword(s):  
Renal Disease ◽  
Left Ventricular Mass ◽  
End Stage Renal Disease ◽  
Left Ventricular ◽  
Ventricular Mass ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Function

scholarly journals Serial Change in Echocardiographic Parameters and Cardiac Failure in End-Stage Renal Disease

2000 ◽  
Vol 11 (5) ◽  
pp. 912-916
Author(s):  
ROBERT N. FOLEY ◽  
PATRICK S. PARFREY ◽  
GLORIA M. KENT ◽  
JOHN D. HARNETT ◽  
DAVID C. MURRAY ◽  
...  
Keyword(s):  
Cardiac Failure ◽  
Left Ventricular ◽  
Volume Index ◽  
Prognostic Information ◽  
Dialysis Therapy ◽  
Lv Mass ◽  
Serial Change ◽  
Stage Renal Disease ◽  
End Stage ◽  
Fractional Shortening

Abstract. Echocardiographic abnormalities are the rule in patients starting dialysis therapy and are associated with the development of cardiac failure and death. It is unknown, however, whether regression of these abnormalities is associated with an improvement in prognosis. As part of a prospective cohort study with mean follow-up of 41 mo, 227 patients had echocardiography at inception and after 1 yr of dialysis therapy. Improvements in left ventricular (LV) mass index, volume index, and fractional shortening were seen in 48, 48, and 46%, respectively. Ninety patients had developed cardiac failure by 1 yr of dialysis therapy. Twenty-six percent of the remaining 137 patients subsequently developed new-onset cardiac failure. The mean changes in LV mass index were 17 g/m2 in those who subsequently developed cardiac failure compared with 0 g/m2 among those who did not (P = 0.05). The corresponding values were -8 versus 0% for fractional shortening (P < 0.0001). The associations between serial change in both LV mass index and fractional shortening and subsequent cardiac failure persisted after adjusting for baseline age, diabetes, ischemic heart disease, and the corresponding baseline echocardiographic parameter. Regression of LV abnormalities is associated with an improved cardiac outcome in dialysis patients. Serial echocardiography adds prognostic information to one performed at baseline.

scholarly journals 3D Echocardiography – A Useful Method for Cardiovascular Risk Assessment in End-Stage Renal Disease Patients

2021 ◽  
pp. S109-S120
Author(s):  
M. Kovářová ◽  
Z. Žilinská ◽  
J. Páleš ◽  
Z. Kužmová ◽  
A. Gažová ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
End Stage Renal Disease ◽  
Left Ventricular ◽  
Structure And Function ◽  
2D Echocardiography ◽  
Diastolic Velocity ◽  
Stage Renal Disease ◽  
End Stage ◽  
And Function ◽  
Esrd Patients

Patients with chronic kidney disease (CKD) have an increased risk of premature mortality, mainly due to cardiovascular causes. The association between hemodialysis and accelerated atherosclerosis has long been described. The ankle-brachial index (ABI) is a surrogate marker of atherosclerosis and recent studies indicate its utility as a predictor of future cardiovascular disease and all-cause mortality. The clinical implications of ABI cut-points are not well defined in patients with CKD. Echocardiography is the most widely used imaging method for cardiac evaluation. Structural and functional myocardial abnormalities are common in patients with CKD due to pressure and volume overload as well as non-hemodynamic factors associated with CKD. Our study aimed to identify markers of subclinical cardiovascular risk assessed using ABI and 2D and 3D echocardiographic parameters evaluating left ventricular (LV) structure and function in patients with end-stage renal disease (ESRD) (patients undergoing dialysis), patients after kidney transplantation and non-ESRD patients (control). In ESRD, particularly in hemodialysis patients, changes in cardiac structure, rather than function, seems to be more pronounced. 3D echocardiography appears to be more sensitive than 2D echocardiography in the assessment of myocardial structure and function in CKD patients. Particularly 3D derived end-diastolic volume and 3D derived LV mass indexed for body surface appears to deteriorate in dialyzed and transplanted patients. In 2D echocardiography, myocardial mass represented by left ventricular mass/body surface area index (LVMI) appears to be a more sensitive marker of cardiac structural changes, compared to relative wall thickness (RWT), left ventricle and diastolic diameter index (LVEDDI) and left atrial volume index (LAVI). We observed a generally favorable impact of kidney transplantation on cardiac structure and function; however, the differences were non-significant. The improvement seems to be more pronounced in cardiac function parameters, peak early diastolic velocity/average peak early diastolic velocity of mitral valve annulus (E/e´), 3D left ventricle ejection fraction (LV EF) and global longitudinal strain (GLS). We conclude that ABI is not an appropriate screening test to determine the cardiovascular risk in patients with ESRD.

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