Influence of long-term amelioration of anemia and blood pressure control on left ventricular hypertrophy in hemodialyzed patients.
The course of left ventricular hypertrophy was investigated in anemic hemodialysis patients treated with recombinant human erythropoietin (r-huEPO). 12 patients, aged 60.8 +/- 9.9 years (mean +/- SD) were treated for 18.8 +/- 2.7 months. Left ventricular size was estimated by echocardiography performed before treatment and at least 12 months after relieving anemia. Patients had signs of left ventricular and/or asymmetric septal hypertrophy when compared with a nonanemic and normotensive control group matched for sex and age. At baseline, hemoglobin (Hb) was 8.6 +/- 0.7 g/dl; interventricular septum thickness (IVST) was 1.75 +/- 0.34 cm, left ventricular posterior wall thickness (LVPWT) 1.32 +/- 0.19 cm, left ventricular muscle mass index (LVMI) 222.7 +/- 41 g/m2 and blood pressure (BP) 146.4 +/- 10/81.6 +/- 6 mm Hg. Hb rose to 11.4 +/- 1.2 g/dl (p less than 0.001); IVST and LVMI decreased to 1.42 +/- 0.35 cm (p less than 0.02) and 155.4 +/- 25.1 g/m2 (p less than 0.001); LVPWT and BP remained unchanged (1.30 +/- 0.26 cm and 146.8 +/- 16.9/81.2 +/- 7.8 mm Hg) at the end of the study. During the observation period, two groups of 5 and 7 patients differed from each other. The group of 5 patients had higher BP values (158.9 +/- 9.8/86.5 +/- 5.3 vs. 140.0 +/- 9.5/79.2 +/- 6.8 mm Hg, p less than 0.01), and the period with Hb values above 10 g/dl was shorter (14.5 +/- 2.4 vs. 17.8 +/- 2.4 months, p less than 0.05). These 5 patients failed to show a significant decrease in IVST and LVMI.(ABSTRACT TRUNCATED AT 250 WORDS)
Zehnder
C
C
Department of Medicine, Kantonsspital Aarau, Switzerland.
Zuber
M
M
Sulzer
M
M
Meyer
B
B
Straumann
E
E
Jenzer
H R
HR
Blumberg
A
A
D000328:Adult; D000704:Analysis of Variance; D000740:Anemia / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D001794:Blood Pressure; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D004452:Echocardiography; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006352:Heart Ventricles; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use; D012016:Reference Values; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors; D016277:Ventricular Function, Left
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin