Department of Nephrology, Tongji Hospital, Tongji University , Shanghai , China.
Ren Fail. 2013 Oct;35(9):1204-9. doi: 10.3109/0886022X.2013.819765. Epub 2013 Aug 1.
This cross-sectional study aims to identify the potential risk factors of left ventricular hypertrophy (LVH) in hemodialysis (HD) patients. Echocardiography, anthropometric measurements and biochemical analyses were performed for 112 HD patients. In univariate analysis, body mass index, systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin, glycated albumin, high sensitivity C-reactive protein (hs-CRP), cardiac troponin T (cTnT), amino-terminal pro-B-natriuretic peptide (NT-proBNP) and carotid artery intima-media thickness were positively correlated with left ventricular mass index (LVMI); pre-albumin, serum creatinine, left ventricular ejection fraction (LVEF) and fractional shortening were negatively correlated with LVMI. Linear regression analysis showed systolic blood pressure, NT-proBNP and LVEF were independently associated with LVMI. According to a binary logistic regression model, higher systolic blood pressure, NT-proBNP and hs-CRP levels showed independent correlation with LVH. Receiver operator characteristic curves analysis showed the associations between NT-proBNP and LVH more closely than hs-CRP and cTnT. The area under the curve for NT-proBNP, hs-CRP and cTnT was 0.762 (95% CI: 0.660-0.864, p < 0.001), 0.734 (95% CI: 0.624-0.844, p < 0.001) and 0.677 (95% CI: 0.563-0.790, p = 0.004), respectively. These data support the main conclusions: hypertension, fluid overload and micro inflammation are associated with LVH in maintenance HD patients. It demonstrates traditional and nontraditional risk factors all play important roles in the development of LVH.
本横断面研究旨在确定血液透析(HD)患者左心室肥厚(LVH)的潜在危险因素。对 112 例 HD 患者进行了超声心动图、人体测量学测量和生化分析。在单因素分析中,体重指数、收缩压、舒张压、糖化血红蛋白、糖化白蛋白、高敏 C 反应蛋白(hs-CRP)、心肌肌钙蛋白 T(cTnT)、氨基末端 pro-B 型利钠肽(NT-proBNP)和颈动脉内膜中层厚度与左心室质量指数(LVMI)呈正相关;前白蛋白、血清肌酐、左心室射血分数(LVEF)和分数缩短与 LVMI 呈负相关。线性回归分析显示收缩压、NT-proBNP 和 LVEF 与 LVMI 独立相关。根据二元逻辑回归模型,较高的收缩压、NT-proBNP 和 hs-CRP 水平与 LVH 独立相关。受试者工作特征曲线分析显示,NT-proBNP 与 LVH 的关联比 hs-CRP 和 cTnT 更密切。NT-proBNP、hs-CRP 和 cTnT 的曲线下面积分别为 0.762(95%CI:0.660-0.864,p<0.001)、0.734(95%CI:0.624-0.844,p<0.001)和 0.677(95%CI:0.563-0.790,p=0.004)。这些数据支持以下主要结论:高血压、液体超负荷和微炎症与维持性 HD 患者的 LVH 相关。这表明传统和非传统危险因素在 LVH 的发展中都起着重要作用。