Cardiac hypertrophy and arterial alterations in end-stage renal disease: hemodynamic factors.

Left ventricular (LV) hypertrophy is the most common cardiovascular alteration observed in end-stage renal disease patients. LV hypertrophy results from chronic flow and pressure overload and combines features of concentric and eccentric hypertrophy. The causes of chronic flow overload are the presence of AV shunt, salt and water overload, and anemia. The pressure overload is related to alterations of physical properties of large arteries characterized by an increased arterial and aortic stiffness. The systolic function of hypertrophied ventricle is preserved, but the diastolic filling is impaired. The ventricular hypertrophy progresses over the time on hemodialysis together with a progressive worsening of both systolic and diastolic functions.