scholarly journals Cardiac Biomarkers and Left Ventricular Hypertrophy in Asymptomatic Hemodialysis Patients

2015 ◽  
Vol 4 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Reneta Yovcheva Koycheva ◽  
Vasil Cholakov ◽  
Jivko Andreev ◽  
Margarit Penev ◽  
Rosen Iliev ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Strong Positive Correlation ◽  
Positive Correlation ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Hs Crp

BACKGROUND: Cardiac biomarkers are often elevated in dialysis patients showing the presence of left ventricular dysfunction. The aim of the study is to establish the plasma levels of high-sensitivity cardiac troponin T (hs TnT), precursor of B-natriuretic peptide (NT-proBNP) and high sensitivity C-reactive protein (hs CRP) and their relation to the presence of left ventricular hypertrophy (LVH) in patients undergoing hemodialysis without signs of acute coronary syndrome or heart failure.MATERIAL AND METHODS: Were studied 48 patients - 26 men and 22 women. Pre and postdialysis levels of hs cTnT, NT-proBNP and hs CRP were measured at week interim procedure. Patients were divided in two groups according to the presence of echocardiographic evidence of LVH - gr A - 40 patients (with LVH), and gr B - 8 patients (without LVH).RESULTS: In the whole group of patients was found elevated predialysis levels of all three biomarkers with significant increase (p < 0.05) after dialysis with low-flux dialyzers. Predialysis values of NT-proBNP show moderate positive correlation with hs cTnT (r = 0.47) and weaker with hs CRP (r = 0.163). Such dependence is observed in postdialysis values of these biomarkers. There is a strong positive correlation between the pre and postdialysis levels: for hs cTnT (r = 0.966), for NT-proBNP (r = 0.918) and for hs CRP (r = 0.859). It was found a significant difference in the mean values of hs cTnT in gr. A and gr. B (0.07 ± 0.01 versus 0.03 ± 0.01 ng /mL, p < 0.05) and NT-proBNP (15,605.8 ± 2,072.5 versus 2,745.5 ± 533.55 pg /mL, p < 0.05). Not find a significant difference in hs CRP in both groups. CONCLUSIONS: The results indicate the relationship of the studied cardiac biomarkers with LVH in asymptomatic patients undergoing hemodialysis treatment.

scholarly journals Left ventricular geometric patterns and cardiac function in patients with chronic renal failure undergoing hemodialysis

2005 ◽  
Vol 64 (1) ◽  
Author(s):  
Maria Teresa Manes ◽  
Manlio Gagliardi ◽  
Gianfranco Misuraca ◽  
Stefania Rossi ◽  
Mario Chiatto
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Diastolic Dysfunction ◽  
Cardiac Troponin ◽  
Ventricular Hypertrophy ◽  
Interventricular Septum ◽  
Myocardial Damage ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Posterior Wall Thickness ◽  
Significant Difference

The aim of this study was to estimate the impact and prevalence of left ventricular geometric alterations and systolic and diastolic dysfunction in hemodialysis patients, as well as the relationship with cardiac troponin as a marker of myocardial damage. Methods: 31 patients (pts), 19 males and 12 females, age 58.1±16.4 (26 on hemodialysis, 5 on peritoneal dialysis) and 31 healthy normal controls were enrolled. Echocardiography measurements were carried out according to the American Society of Echocardiography recommendations. Left ventricular mass was calculated, according to the Devereux formula and indexed to height and weight 2.7. Doppler echocardiography was performed to study diastolic function by measurements of isovolumetric relaxation period (IVRT), E wave deceleretion time (DTE) and E/A ratio. Cardiac troponin was measured by a third generation electrochemiluminescence immunoassay. Statistical analysis was performed using the t-test for between-group comparisons and the Pearson and Spearman’s tests to investigate correlations; p values of &lt;0.05 were considered statistically significant. Results: Eccentric hypertrophy was the most frequent pattern (n=17; 55%), followed by normal cardiac geometry (n=7; 23%), and concentric hypertrophy (n=5; 16%). Only 6% of pts (n=2) showed concentric remodelling. Systolic dysfunction was present in terms of endocardial parameters in 3 pts (9%) (fractional shartening &lt;25%, EF&lt;50%), but in terms of midwall myocardial shortening in 51% (n=16). Diastolic dysfunction was present in 87% (n=27) with a pattern of impaired relaxation (in 5 without left ventricular hypertrophy). E/A was negatively correlated with age (r=-0.41, p=0.02); DTE was positively correlated with posterior wall thickness (r=0.36, p=0.05) and interventricular septum thickness (r=0.45, p=0.01); cardiac troponin was positively correlated with age (r=0.50, p=0.00), left ventricular mass (r=0.41, p=0.02), posterior wall thickness (r=0.41; p=0.02) and interventricular septum thickness (r=0.39, p=0.03) but not with diastolic dysfunction parameters. No significant difference was found in terms of duration of dialysis between patients with normal left ventricular geometry and those with left ventricular hypertrophy, but a significant difference in age was found (p=0.03). Pts with diastolic dysfunction had more frequent hypotensive episodes during dialysis (p &lt;0.01). Conclusion: Impaired geometry and cardiac function is frequently observed in pts undergoing hemodialysis. Diastolic dysfuction is associated to a geometric pattern of left ventricular hypetrophy, although it can be an isolated initial manifestation of myocardial damage. Depressed midwall myocardial shortening can discriminate left ventricular dysfunction better than traditional endocardial systolic indexes.

Abstract 17246: Sensitivity and Specificity of Relative Sparing of Apical Longitudinal Strain for Detection of Systemic Light-Chain Amyloidosis versus Transthyretin Amyloidosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Michael Jiang ◽  
Julia M Simkowski ◽  
Nadia El Hangouche ◽  
Jeesoo Lee ◽  
Milica Marion ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Sensitivity And Specificity ◽  
Light Chain ◽  
Longitudinal Strain ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Control Group ◽  
Transthyretin Amyloidosis ◽  
Light Chain Amyloidosis ◽  
Significant Difference

Introduction: Relative apical sparing of longitudinal strain (RALS, the ratio of apical strain vs the rest of the heart) on echocardiography has been found to have high sensitivity and specificity for differentiating cardiac amyloidosis (CA) from other causes of left ventricular hypertrophy. Previous studies have shown no significant difference between amyloid subtypes, systemic light-chain amyloidosis (AL) and transthyretin amyloidosis (ATTR) Hypothesis: There will be a significant difference in sensitivity and specificity of RALS to detect CA across amyloid subtypes. Methods: A cohort of patients with either AL or ATTR amyloid was identified, with a control cohort of patients with left ventricular hypertrophy (LVH) of other etiologies. Speckle tracking echocardiography was performed on EchoPAC (GE Medical Systems) software to obtain values of basal, mid, and apical longitudinal strain for each patient; relative apical strain was then calculated. Results: The TTR group (n=22) was older (66.4±7.9, 76.6±11.6, p=0.001) and more likely to be female (p=0.009) than the AL group (n=30), both groups had similar rates of hypertension, diabetes mellitus, and end stage renal disease. Echocardiographic markers of diastolic function were decreased in both groups; the AL group had decreased left ventricle end diastolic volume (60.9±25.5, 94.9±50.2, p=0.012) and mean wall thickness (1.4±0.3, 1.6±0.4 p=0.017). ROC analysis using a RALS cutoff of 2 to differentiate AL and ATTR from the LVH control group revealed similar specificity (AL 85%, ATTR 85%) and sensitivity (AL 40%, ATTR 50%). Difference in area-under-curve (AUC) was not significant (p=0.2) (figure). Conclusions: ATTR and AL amyloid have similar specificity, but ATTR has a trend towards improved sensitivity over AL for detection of CA using RALS with the previously validated threshold of 2. This might become significant with a larger sample, work that is currently on-going..

Blood Pressure Control and Left Ventricular Hypertrophy in Long-Term Capd and Hemodialysis Patients: A Cross-Sectional Study

2003 ◽  
Vol 23 (6) ◽  
pp. 563-567 ◽  
Author(s):  
Ali Ihsan Günal ◽  
Erdogan Ilkay ◽  
Ercan Kirciman ◽  
Ilgin Karaca ◽  
Ayhan Dogukan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Hypertrophy ◽  
Wall Thickness ◽  
Left Atrial ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Volume Control ◽  
Left Ventricular Chamber ◽  
Significant Difference

Background It is still not clear whether hypertension and left ventricular hypertrophy (LVH) are more common in continuous ambulatory peritoneal dialysis (CAPD) than in hemodialysis (HD) patients. Methods To examine this subject, the indices of cardiac performance were compared between 50 HD and 34 CAPD patients. Patients were further divided into two subgroups [long-term (L) CAPD and L-HD] according to dialysis modality and duration of dialysis (more than 60 months’ duration). Results The blood pressure and cardiothoracic index of CAPD patients did not differ from HD patients. On average, the left atrial index was 2 mm/m2 higher in HD patients than in CAPD patients. Left ventricular chamber sizes, wall thickness, and left ventricular mass index (LVMI) in patients on CAPD were similar to those of HD patients. Isovolumic relaxation time (IVRT) of CAPD patients was insignificantly less than that of HD patients (101 ± 22 and 115 ± 27 msec respectively). There was no significant difference between the two subgroups (L-HD and L-CAPD) in blood pressure, left atrial diameter, left ventricular chamber size, wall thickness, LVMI, ejection fraction, or IVRT. Conclusion If normovolemia and normotension are obtained by strict volume control without using antihypertensive drugs, the effects of the two modalities of chronic dialysis treatment (HD and CAPD) on cardiac structure and function are not different from each other.

scholarly journals Fibroblast Growth Factor 23, High-Sensitivity Cardiac Troponin, and Left Ventricular Hypertrophy in CKD

2013 ◽  
Vol 61 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Kelsey Smith ◽  
Christopher deFilippi ◽  
Tamara Isakova ◽  
Orlando M. Gutiérrez ◽  
Karen Laliberte ◽  
...  
Keyword(s):  
Growth Factor ◽  
Left Ventricular Hypertrophy ◽  
Fibroblast Growth Factor ◽  
Cardiac Troponin ◽  
Ventricular Hypertrophy ◽  
Fibroblast Growth Factor 23 ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Fibroblast Growth

scholarly journals Correlation between echocardiographic left ventricular hypertrophy and microalbuminuria among hypertensive subjects in Olabisi Onabanjo university teaching hospital, Sagamu, Nigeria

2020 ◽  
Vol 7 (7) ◽  
pp. 1141
Author(s):  
Olajide O. Oresegun ◽  
Oluranti B. Familoni ◽  
Taiwo O. Olunuga ◽  
Akintunde Akinpelu
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Left Ventricular Mass ◽  
Ventricular Hypertrophy ◽  
Urinary Albumin Excretion ◽  
Left Ventricular ◽  
Urinary Albumin ◽  
University Teaching ◽  
Positive Correlation ◽  
Albumin Excretion ◽  
Ventricular Mass

Background: Left ventricular hypertrophy is an adaptive response to volume and/or pressure overload, especially in hypertensive subjects. Microalbuminuria is a well-known predictor of poor cardiovascular outcomes in patients with hypertension. The purpose of this study was to determine the prevalence of microalbuminuria in hypertensive subjects and its relationship with LVH defined by echocardiogram in adult hypertensive subjects.Methods: The study was a cross-sectional comparative one involving 88 hypertensive volunteers with age and sex-matched normotensive controls. Detailed history, physical examination, urine assessment for microalbuminuria and echocardiogram were carried out on all participants.Results: The overall prevalence rate of microalbuminuria in the study was 29.5%. The prevalence of microalbuminuria in hypertensive subjects (43.2%) was significantly higher than in the normotensive counterparts (15.9%) (p=0.001). The prevalence of microalbuminuria in hypertensive subjects with echocardiographic LVH (81.0%) was significantly higher than in hypertensive participants without echocardiographic LVH (31.3%) (p=0.001). There was a positive correlation between left ventricular mass defined by echocardiogram and urinary albumin excretion in hypertensive subjects (r =0.422, p= 0.001).Conclusions: There is a high prevalence of microalbuminuria among hypertensive adults, especially those with left ventricular hypertrophy. There is also a positive correlation between echocardiographic left ventricular mass and urinary albumin excretion among adult hypertensive subjects.

scholarly journals Relation between Oscillometric Measurement of Central Hemodynamics and Left Ventricular Hypertrophy in Hypertensive Patients

Pulse ◽  
2021 ◽  
pp. 1-9
Author(s):  
Masakazu Obayashi ◽  
Shigeki Kobayashi ◽  
Takuma Nanno ◽  
Yoriomi Hamada ◽  
Masafumi Yano
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Augmentation Index ◽  
Characteristic Curve ◽  
Left Ventricular ◽  
Applanation Tonometry ◽  
Central Hemodynamics ◽  
Prognostic Information ◽  
Hypertensive Patients ◽  
Significant Difference

<b><i>Introduction:</i></b> The augmentation index (AIx) or central systolic blood pressure (SBP), measured by radial applanation tonometry, has been reported to be independently associated with left ventricular hypertrophy (LVH) in Japanese hypertensive patients. Cuff-based oscillometric measurement of the AIx using Mobil-O-Graph® showed a low or moderate agreement with the AIx measurement with other devices. <b><i>Methods:</i></b> The AIx measured using the Mobil-O-Graph was validated against the tonometric measurements of the radial AIx measured using HEM-9000AI in 110 normotensive healthy individuals (age, 21–76 years; 50 men). We investigated the relationship between the central hemodynamics assessed using the Mobil-O-Graph and LVH in 100 hypertensive patients (age, 54–75 years; 48 men), presenting a wall thickness of ≥11 mm and ≥10 mm in men and women, respectively. <b><i>Results:</i></b> Although the Mobil-O-Graph-measured central AIx showed no negative values, it correlated moderately with the HEM-9000AI-measured radial AIx (<i>r</i> = 0.602, <i>p</i> &#x3c; 0.001) in the normotensive individuals. The hypertensive patients did not show a significant difference in the central SBP between the sexes, but the central AIx was lower in men than in women. The independent determinants influencing left ventricle (LV) mass index (LVMI) (<i>R</i><sup>2</sup> = 0.362; adjusted <i>R</i><sup>2</sup> = 0.329, <i>p</i> &#x3c; 0.001) were heart rate (β = −0.568 ± 0.149, <i>p</i> &#x3c; 0.001), central SBP (β = 0.290 ± 0.100, <i>p</i> = 0.005), and aortic root diameter (β = 1.355 ± 0.344, <i>p</i> = 0.001). Age (β = −0.025 ± 0.124, <i>p</i> = 0.841) and the central AIx (β = 0.120 ± 0.131, <i>p</i> = 0.361) were not independently associated with the LVMI. The area under the receiver operator characteristic curve to evaluate the diagnostic performance of the central AIx for the presence of LVH (LVMI &#x3e;118 g/m<sup>2</sup> in men or &#x3e;108 g/m<sup>2</sup> in women) was statistically significant in men (0.875, <i>p</i> &#x3c; 0.001) but not in women (0.622, <i>p</i> = 0.132). In men, a central AIx of 28.06% had a sensitivity of 83.3% and specificity of 80.0% for detecting LVH. <b><i>Conclusions:</i></b> AIx measurement in men provided useful prognostic information for the presence of LVH. Pulse-wave analysis assessed using the Mobil-O-Graph may be a valuable tool for detecting LVH in hypertensive patients.

scholarly journals Effect of persistence of left ventricular hypertrophy and left atrial dilatation after aortic valve replacement on early outcomes and survival: a prospective study

2019 ◽  
Vol 6 (10) ◽  
pp. 3786
Author(s):  
Hari Krishna Murthy P. ◽  
Abha Chandra
Keyword(s):  
Aortic Valve ◽  
Left Ventricular Hypertrophy ◽  
Aortic Stenosis ◽  
Left Atrial ◽  
Ventricular Hypertrophy ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
Significant Difference ◽  
A Prospective Study

Background: The objective of the study was to evaluate the early outcomes and survival in patients with severe aortic stenosis associated with concentric left ventricular hypertrophy following aortic valve replacement.Methods: This is a prospective study done at SVIMS, Tirupati, from June 2014 to September 2015 evaluating out comes and survival in patients undergoing primary isolated aortic valve replacement (AVR) for severe aortic stenosis, severe aortic stenosis with mild aortic regurgitation and severe aortic stenosis with moderate aortic regurgitation.Results: A total of 40 cases 26 males and 14 females aged 18 to 60 years (mean age, 48.5±13.4 years) underwent elective AVR. Left ventricular end diastolic diameter (p=0.008) at 6 months, a statistically highly significant difference in left ventricular mass  preoperatively, at discharge, at 3rd and 6th month follow up. The difference in mean left ventricular mass index (LVMI) had declined from 244.425 to 141.100 at 6 months, showing a statistically highly significant difference in LVMI preop, at discharge, at 3rd month and at 6th month follow up.Conclusions: Patients with preoperative increase in LVMI, with large left atrial diameter carries a strong predictor of postoperative mortality for patients undergoing aortic valve surgery. We also conclude that there will be significant regression of LVMI following successful AVR. But, the decrease in LVMI is maximum during early three months and it is minimal though significant in the later course of follow up. 

Zmiany w EKG o charakterze przerostu lewej komory z zaburzeniami repolaryzacji – możliwe trudności diagnostyczne na podstawie opisu przypadku

2018 ◽  
Vol 21 (2) ◽  
Author(s):  
Mariusz Bodnar ◽  
Joanna Mazurkiewicz ◽  
Jacek Różański
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Public Health Problem ◽  
Final Diagnosis ◽  
Left Ventricular ◽  
Global Public Health ◽  
Hypertensive Nephropathy ◽  
Coronary Syndrome

Electrocardiographic changes of the nature of left ventricular hypertrophy with repolarization abnormalities may cause some diagnostic difficulties in the outpatient setting resulting from the etiology of changes. Chronic kidney disease (CKD) is a global public health problem that shortens lifespan, primarily by increasing risk of cardiovascular disease. Left ventricular hypertrophy (LVH) is a common pattern of cardiovascular injury in CKD that affects up to 75% of individuals by the time they reach end-stage renal disease. By promoting heart failure and atrial and ventricular arrhythmias, LVH is a powerful risk factor for cardiovascular events and death. The complex pathogenesis of LVH involves ventricular pressure and volume overload and the electrocardiographic record alone may sometimes suggest suspicion of an acute coronary syndrome. In this paper, we describe the case of a 39-year-old patient who was referred to the Cardiology Clinic with a preliminary diagnosis of „infarctus myocardia in evolution”, however, the final diagnosis was chronic kidney disease in stage 5 on a base of hypertensive nephropathy (not biopsy proven).

Abstract 124: The Effectiveness of Angiotensin Converting Enzyme Inhibitors, Angiotensin II Receptor blocker, or Combination in Reducing Left Ventricular Hypertrophy in Hypertensive Patients: A Systematic Review

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Roland F Njoh ◽  
Basile Njei ◽  
An Thu Nguyen
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Enzyme Inhibitors ◽  
Data Extraction ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Left Ventricular ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Hypertensive Patients ◽  
Significant Difference

Background: Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are well established antihypertensive medications. Their role in reducing left ventricular hypertrophy (LVH) over other antihypertensives has also been clearly delineated on previous trials and meta-analysis. However, the difference in LVH reduction between ACEIs, ARBs or their combination is still unknown. Data Sources: The Cochrane Control Trials Register, PUBMED (1970 to April 2012), and hand selected reference list of English-language trials. Study Selection: Fourteen clinical trials comparing ACEI, ARB or both with outcome of interest in hypertensive patients, with duration of at least 6 months and that had minimum 20 patients were found. Data extraction: A predefined data extraction protocol was establish that included study reference, objective, design, population demographics, various interventions, outcomes and study quality. Results: Eleven randomized double blinded trials, 2 randomized open label trials and one case control trials were identified. Nine compared ACEI to ARB only and the remaining 5 compared ACEI, ARB with ACEI and ARB. There is high evidence that the use of ACEI or ARB in hypertensive patient with LVH for duration of at least 6 months, results in significant reduction in left ventricular hypertrophy measured by echocardiography or MRI as left ventricular mass (LVM) and or left ventricular mass index (LVMI). There is no significant difference between the use of ACEI or ARB in LVH reduction. When comparing combination therapy of ACEI and ARB to monotherapy of either ACEI or ARB, there is some evidence of further regression in LVH with combination therapy. The difference was more pronounced in diabetics. Limitations: Studies had small sample sizes with varied duration of therapy in diverse clinical settings, using different ACEIs and ARBs. Conclusion: The current evidence shows that the use of ACEI or ARB in hypertensive patients with LVH results in reduction in LVH. There is no significant difference in LVH reduction between use of ACEI or ARB. The use of both ACEI and ARB provides additional reduction in LVH especially in diabetics; there is however need for larger studies to better delineate these differences.

scholarly journals Left ventricular dysfunction in hypertensive patients: an echocardiographic assessment

2018 ◽  
Vol 8 (3) ◽  
pp. 51-56
Author(s):  
Rishi Khatri ◽  
Devendra Khatri ◽  
Dhan Bahadur Shrestha ◽  
Parag Karki ◽  
Chiranjeevi Panta ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Diastolic Dysfunction ◽  
Ventricular Hypertrophy ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Age Distribution ◽  
Left Ventricular ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Significant Difference

Introduction: Echocardiography is noninvasive procedure to assess heart. Ventricular mass increases due to left ventricular hypertrophy and performance of left ventricle decreases with increase in blood pressure. Left ven­tricular diastolic dysfunction (LVDD) is early sign of heart weakness which can be picked up early with Echo. This study was aimed to study cardiac anatomic and functional parametric alteration in echocardiography among hypertensive patients. Methods: This was a non-invasive, cross sectional hospital based retrospective review of the patient record from echo room among the hypertensive patient who undergone echocardiographic as­sessment from September 2017-February 2018 in Shree Birendra Hospital (SBH), Chhauni, Kathmandu. Results: Among 447 hypertensive cases, 232(51.9%) were having normal diastolic function while rest 215(48.1%) were having diastolic dysfunction of the heart. Among total cases evaluated, only 12(2.7%) patients were having ejec­tion fraction lower than 55%, while in rest it was normal. There were 53 (11.9%) cases having some form of as­sociated complication. Gender, Concentric Left Ventricular Hypertrophy and left atrial dilatation has significant difference (p<0.05) with LVDD. Statistically significant differences in age distribution of individuals with different categories of left ventricular systolic dysfunction (LVSD) and LVDD (p˂0.001) was observed. Conclusion: Signifi­cant number of hypertensive individuals were having LVDD though in most of the individual LV ejection fraction was maintained.

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