Reverse correlation between ankle-brachial index and left ventricular hypertrophy in patients on maintenance haemodialysis.

BACKGROUND

Left ventricular hypertrophy (LVH) and peripheral vascular disease (PVD) are highly prevalent among patients undergoing maintenance haemodialysis (MHD) and contribute to most cardiovascular mortalities in this population. Ankle-brachial index (ABI) has been recently demonstrated to be a predictor for all-cause and cardiovascular mortality in MHD Patients. The main objective of the present study is to see whether ABI is correlated with LVH in MHD patients.

METHODS

One hundred and sixteen MHD patients selected from our dialysis unit were enrolled in this study. Colour Doppler ultrasonic examinations were performed at their hearts, both lower extremities and non-fistula upper extremities to determine the morphological and haemodynamic changes of their hearts and the systolic pressures of both their posterior tibial arteries, dorsalis pedis arteries and non-fistula brachial arteries. ABI was calculated on the basis of systolic pressures of the lower extremities and non-fistula upper extremities, and the correlation between ABI and LVH was analysed.

RESULTS

Seventy-four (63.8%) MHD patients presented with LVH and related haemodynamic changes of varying degrees. There was a significant difference in ABI between the LVH group and the non-LVH group (0.96 +/- 0.15 vs 1.25 +/- 0.12, P < 0.001). Bivariate analysis showed that left ventricular mass index (LVMI) was negatively correlated with ABI, serum Alb and Hb (r = -0.482, -0.329, -0.247, P < 0.01), positively correlated with hypertension, serum calcium, serum phosphorus and calcium-phosphorus product. (r = 0.235, 0.168, 0.231,0.282, P < 0.05), and ABI was reversely correlated with hypertension, serum calcium, serum phosphorus and calcium-phosphorus product. (r = -0.195, -0.405, -0.271, -0.384, -0.461, P < 0.05), positively correlated with serum albumin (r = 0.338, P < 0.001). Multiple linear regression demonstrated ABI was independently associated with LVMI in MHD patients (beta = -103.522, P = 0.000).

CONCLUSION

There is high incidence of LVH and decreased ABI in MHD patients. A decrease in ABI to some extent reflects the degree of LVH in this population.