Assessment of left ventricular mass in dialysis patients
Abstract
The aim of this study was to estimate mass of left ventricular (LVM) with the Devereux formula before and after hemodialysis and to compare two methods of indexation of LVM: LV mass/body surface area (g/m2) and LV/mass/height (g/m2,7). Thirty dialysis patients (17F, 13M, mean age 49 ± 11 years) who received bicarbonate HD for 4 hours 3 times a week were studied. M-mode echocardiography was performed and LVM was calculated by Devereux formula. Left ventricular mass index (LVMI) was calculated using two methods: LV mass/body surface area (g/m2) and LV mass/height (g/m2,7). All measures were performed an hour before and immediately after HD by one investigator. Criteria of left ventricular hypertrophy (g/m2 vs. g/m2,7) was detected in 27 (90%) and 28 (93%) patients, respectively. After hemodialysis ILVM was different from its initial level by -35,0% to +34,9% (percents from initial level) for g/m2 indexation and by -33,0% to +35,3% for g/m2,7 indexation. There was significant positive correlation (r = 0,97; p < 0,001) between ∆ILVM (g/m2) and ∆ILVM (g/m2,7). ∆ILVM (g/m2) and ∆ILVM (g/m2,7) were associated with dynamics of left ventricular end diastolic diameter (LVEDD). A positive correlation between ∆LVEDD and amount of ultrafiltration was found. The data show that LVM calculated by Devereux formula is different before and after hemodialysis session. There are no significant difference between indexation of LVM on body surface area (g/m2) or on height2,7 (g/m2,7).
About the Authors
A. M. Shutov
Кафедра терапии и профессиональных болезней медицинского факультета Ульяновского государственного университета, Ульяновская областная клиническая больница, Ульяновск
Russian Federation
Russian Federation
O. M. Edigarova
Кафедра терапии и профессиональных болезней медицинского факультета Ульяновского государственного университета, Ульяновская областная клиническая больница, Ульяновск
Russian Federation
Russian Federation
V. E. Mastykov
Кафедра терапии и профессиональных болезней медицинского факультета Ульяновского государственного университета, Ульяновская областная клиническая больница, Ульяновск
Russian Federation
Russian Federation
References
1. Клиническое руководство по ультразвуковой диагностике. Под ред. В.В. Митькова и В.А. Сандрикова. 1998: 5.
2. Профилактика, диагностика и лечение первичной артериальной гипертонии в Российской Федерации. Первый доклад экспертов научного общества по изучению артериальной гипертонии Всероссийского научного общества кардиологов и Межведомственного совета по сердечно-сосудистым заболеваниям (ДАГ-1). Клиническая фармакология и терапия 2000; 3: 5-30.
3. Сидоренко Б.Ф., Преображенский Д.В. Гипертрофия левого желудочка: патогенез, диагностика и возможность обратного развития под влиянием антигипертензивной терапии. Кардиология 1998; 5: 80-85.
4. Шиллер Н., Осипов М.А. Клиническая эхокардиография. М., 1993.
5. Abergel E., Tase M., Bohlader J. Which definition for echocardiographic left ventricular hypertrophy? Am J Cardiol 1995; 75: 486-503.
6. De Simone G., Devereux R.B., Daniels et al. Effect of growth on variability of left ventricular mass: assessment of allometric signals in adults and children and their capacity to predict cardiovascular risk. J Am Coll Cardiol 1995; 25: 1056-1062.
7. Devereux R.B., Alomso D.R., Lutas E.M. et al. Echocardiographic assessment of left ventricular hypertrophy comparison to necropsy findings. Am J Cardiol 1986; 57: 450-458.
8. Devereux R.B., Bella J., Boman K. et al. Echocardiographic left ventricular geometry in hypertensive patients with electrocardiographic left ventricular hypertrophy: The LIFE Study Blood press 2001; 10: 74-82.
9. Johnstone L.M., Jones C.L., Grigg L.E. et al. Left ventricular abnormalities in children, adolescents and young adults with renal disease. Kidney Int 1996; 50: 998-1006.
10. Levy D., Garrison R.J., Savage D.D. et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 1990; 322: 1561-1566.
11. Levy D.D., Solomon M.S., D’Agostino R.B. et al. Prognostic implications of baseline electrocardiographic features and their serial changes in subjects with left ventricular hypertrophy. Circulation 1994; 90: 1786-1793.
12. Martin L.C., Barretti P., Cornejio I.V. et al. Influence of fluid volume variations on the calculated value of the left ventricular mass measured by echocardiogram in patients submitted to hemodialysis. Ren Fail 2003; 25: 43-45.
13. Mitsnefes M.M., Schwartz S.M., Daniels S.R. et al. Changes in left ventricular mass index in children and adolescents after renal transplantation. Pediatr Transplant 2001; 5: 279-284.
14. Sahn D.J., DeMaria A., Kissio J., Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072-1083.
15. Schiller N.B., Shan P.M., Crawford M. et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 1989; 2: 358-367.
16. Silberberg J.S., Barre P.E., Prichard S.S., Sniderman A.D. Impact of the left ventricular hypertrophy on survival in end-stage renal disease. Kidney Int 1989; 36: 286-290.
17. Stewart G.A., Foster J., Cowan M. et al. Echocardiography overestimates left ventricular mass in hemodialysis patients relative to magnetic resonance imaging. Kidney Int 1999; 56: 2248-2253.
Review
For citations:
Shutov A.M., Edigarova O.M., Mastykov V.E. Assessment of left ventricular mass in dialysis patients. Nephrology and Dialysis. 2004;6(2):177-180. (In Russ.)
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