Left ventricular geometry and its relationship with properties of arterial vessels in patients with chronic kidney disease

Abstract

Background Left ventricular remodeling begins in early stages of chronic kidney disease and there are several types of it, which differ in respect to pathogenesis and prognostic significance. The study aimed to assess the prevalence of different types of left ventricular geometry in CKD patients and its relationship with properties of arterial vessels — pulse wave velocity and common carotid artery intima-media thickness.
Material and methods The study population consisted of 60 stage 3.-5. CKD patients aged 25-79 years, with mean eGFR 32.8 ± 13.7 ml/min/1.73 m² estimated using MDRD formula. On echocardiography left ventricular mass index (LVMI), relative wall thickness (RWT) and ejection fraction (EF) were assessed. Carotid-femoral PWV measurement and IMT measurement were also performed. Based on LVMI and RWT four types of left ventricular geometry were defined.
Results Normal left ventricular geometry (N) was found in 21.7% of patients, concentric remodeling (R) in 21.7%, concentric hypertrophy (K) in 41.6% and eccentric hypertrophy (E) in 15%. Elevated PWV and IMT were found in patients with K and elevated PWV and decreased EF were found in patients with E when compared with CKD patients with N. Statistically significant positive correlation was found between PWV and LVMI, IMT and LVMI, IMT and RWT and negative between IMT and EF.
Conclusions Abnormal left ventricular geometry was found in almost 80% stage 3.-5. CKD patients. Increased arterial stiffness is associated with concentric left ventricular hypertrophy, and increased carotid IMT is associated with both, concentric and eccentric left ventricular hypertrophy and impaired left ventricular systolic function.
Arterial Hypertension 2010, vol. 14, no 6, pages 451-459