Document Detail


Left atrial volume in end-stage renal disease: a prospective cohort study.
MedLine Citation:
PMID:  16685218     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: End-stage renal disease (ESRD) is a high-risk condition and left ventricular hypertrophy (LVH) is the strongest risk factor in this population. OBJECTIVE AND METHODS: Since the prognostic value of left atrial (LA) size in ESRD is still unknown, we performed a prospective cohort study aimed at testing the prognostic value of LA volume in a cohort of 249 ESRD patients. RESULTS: Both un-indexed and indexed LA volume (LAV) was significantly higher in dialysis patients than in healthy subjects (P < 0.001). On multivariate analysis only left ventricular mass index (LVMI), LV ejection fraction (LVEF), ratio of early (E) to late atrial (A) mitral Doppler peak flow velocity (E/A ratio) and antihypertensive treatment maintained an independent association with LAV. During the follow-up 113 patients died. LAV added significant prognostic power to a multivariate Cox model of all-cause death and the model based on height provided the best data fit. Notably, this index maintained an independent predictive value for death (P = 0.03) also when LVMI and LVEF were jointly forced into the Cox's model. Neither crude nor body surface area (BSA)-adjusted LAV had an independent association with death when tested in the Cox model including LVMI and LVEF. CONCLUSIONS: In patients with ESRD, LAV indexed for height displays prognostic value beyond and above that provided by LV mass and function.
Authors:
Giovanni Tripepi; Francesco Antonio Benedetto; Francesca Mallamaci; Rocco Tripepi; Lorenzo Malatino; Carmine Zoccali
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  24     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-10     Completed Date:  2006-08-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1173-80     Citation Subset:  IM    
Affiliation:
CNR-IBIM, Institute of Biomedicine, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension and Division of Nephrology, Reggio Calabria, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Body Height
Body Surface Area
Cardiac Volume / physiology
Cause of Death
Female
Heart Atria / pathology*,  physiopathology
Heart Ventricles / pathology
Humans
Kidney Failure, Chronic / mortality,  pathology*,  physiopathology
Male
Middle Aged
Prospective Studies
Ventricular Dysfunction / pathology

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