title: Reversal of left ventricular hypertrophy following recombinant human erythropoietin treatment of anaemic dialysed uraemic patients.
abstract: To clarify the role of chronic anaemia in the pathogenesis of the left ventricular hypertrophy (LVH) of chronic uraemia, nine normotensive dialysed patients were studied before and 3 and 6 months after start of intravenous treatment with recombinant human erythropoietin (rHuEpo). M-Mode echocardiographic estimations of left ventricular mass indices (LVMi) and plasma noradrenaline determinations were made at 3 and 6 months, and total blood volume (TBV) only at 6 months. Resting haemoglobin values were 5.9 +/- 1.3 (SD) g/dl, increased within 3 months to 10.2 +/- 1.2 (P less than 0.001), then remained unchanged. Baseline LVMi was 115 +/- 18 g/m2 body surface area (b.s.a.) and decreased significantly (P less than 0.0025) over the entire period to a final value of 78 +/- 13 g, which did not differ from the average value for 19 healthy controls. Resting plasma noradrenaline was 1.45 +/- 0.44 pmol/ml and did not change significantly, although values were reduced at the 3rd month, when decreased heart rates and slightly and non-significantly increased blood pressures were recorded. TBV did not vary because the increased erythrocyte mass was compensated for by parallel decreases in plasma volume. These data demonstrate the existence of a cause-effect relationship between uraemic anaemia and LVH, although the precise mechanism remains unknown. Amelioration of anaemia with rHuEpo, by allowing recovery from the attendant LVH, might improve long-term cardiovascular prognosis in some dialysed uraemic patients.
authors.affiliation: Institute of Nephrology, School of Medicine, University of Brescia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cannella
authors.forename: G
authors.initials: G
authors.lastname: La Canna
authors.forename: M
authors.initials: M
authors.lastname: Sandrini
authors.forename: M
authors.initials: M
authors.lastname: Gaggiotti
authors.forename: G
authors.initials: G
authors.lastname: Nordio
authors.forename: E
authors.initials: E
authors.lastname: Movilli
authors.forename: S
authors.initials: S
authors.lastname: Mombelloni
authors.forename: O
authors.initials: O
authors.lastname: Visioli
authors.forename: R
authors.initials: R
authors.lastname: Maiorca
mesh_terms: D000328:Adult; D000740:Anemia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D004452:Echocardiography; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D006435:Renal Dialysis; D014511:Uremia / Q000150:complications* / Q000503:physiopathology / Q000628:therapy
chemical_list: D004921:Erythropoietin; D009638:Norepinephrine