Left ventricular hypertrophy and diastolic dysfunction

Kidney patients and their heart problems

Patients with chronic renal failure (CRF) on maintenance hemodialysis (HD) experience a series of metabolic and hemodynamic abnormalities that predispose to anatomic and functional change in myocardial performance¹. Thus, left ventricular (LV) hypertrophy, a geometric change independently predictive of mortality^2,3, is usually accompanied by diastolic dysfunction. Left ventricular systolic dysfunction seems to be less frequent^4,5, although it also adds prognostic value⁶.

REFERENCES

1. Alpert MA. Cardiac performance and morphology in end-stage renal disease. Am J Med Sci. 2003; 325: 168-78. [ Links ]

2. Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC, Barre PE. The prognostic importance of left ventricular geometry in uremic cardiomyopathy. J Am Soc Nephrol. 1995; 5: 2024-31. [ Links ]

3. London GM. Cardiovascular disease in chronic renal failure: pathophysiologic aspects. Semin Dial. 2003; 16: 85-94. [ Links ]

4. Sarnak MJ. Cardiovascular complications in chronic kidney disease. Am J Kidney Dis. 2003; 41: 11-7. [ Links ]

5. London GM. Left ventricular alterations and end-stage renal disease. Nephrol Dial Transplant. 2002; 17 Suppl 1: 29-36. [ Links ]

6. Sarnak MJ, Levey AS, Schoolwerth AC, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation 2003; 108: 2154-69. [ Links ]