Document Detail


Left ventricular geometry and cardiovascular mortality based on haemodialysis patient autopsy analyses.
MedLine Citation:
PMID:  20649875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: In end-stage renal disease (ESRD) patients, left ventricular hypertrophy (LVH) is common and a risk for cardiovascular events. LVH is geometrically classified into two major groups, concentric and eccentric, and accumulating evidence suggests eccentric LVH has a more negative effect than concentric LVH on ESRD outcome. However, there have been very few studies on the cardiac findings from ESRD patient autopsy in which the relationship between LVH geometry and mortality was analyzed. METHODS: An observational study was performed with the autopsy findings in 30 haemodialysis patient cases between 2001 and 2006 at Mitsui Memorial Hospital, Tokyo. Between those who died of a cardiovascular cause and those who died of non-cardiovascular causes, we compared the heart/bodyweight ratio, left ventricular dilatation, and the extent of fibrosis of the left ventricle. RESULTS: Heart/bodyweight ratio was significantly higher (P < 0.0001) in the cardiovascular mortality group (n = 11, 11.7 +/- 2.5 g/kg) compared to the non-cardiac cause of death group (n = 19, 8.05 +/- 0.7 g/kg). The dilatation of the left ventricle was significantly more frequent in the cardiovascular than the non-cardiac cause of death group (P = 0.016). Additionally, the fibrotic area of left ventricular cross-section was larger in the cardiovascular (1.63 +/- 1.6%) than the non-cardiac group (0.83 +/- 1.7%, P = 0.04). CONCLUSION: This autopsy study indicates that eccentric LVH in haemodialysis patients is closely associated with cardiovascular mortality. LVH geometry, as well as LVH severity, is worthy of consideration as a clinical predictor for cardiovascular mortality.
Authors:
Imari Mimura; Hiroshi Nishi; Naobumi Mise; Masaya Mori; Tokuichiro Sugimoto
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  15     ISSN:  1440-1797     ISO Abbreviation:  Nephrology (Carlton)     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  549-54     Citation Subset:  IM    
Affiliation:
Division of Nephrology and Endocrinology, University of Tokyo School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Autopsy
Cardiovascular Diseases / etiology,  mortality*,  pathology
Cause of Death
Chi-Square Distribution
Cross-Sectional Studies
Female
Fibrosis
Heart Ventricles / pathology*
Humans
Hypertrophy, Left Ventricular / etiology,  mortality,  pathology*
Japan
Kidney Failure, Chronic / complications,  mortality,  therapy*
Male
Renal Dialysis* / mortality
Risk Assessment
Risk Factors
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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