Cardiac magnetic resonance imaging in hemodialysis patients.
BACKGROUND
The anatomy of left ventricular hypertrophy (LVH) in dialysis patients was studied with magnetic resonance imaging (MRI). Potential benefits of spironolactone were examined in a subset of patients.


METHODS
This was a prospective case series of 30 hemodialysis patients in whom cardiac MRI was performed. Repeat MRI was done in a subset of 13 patients after 9 months of daily oral spironolactone 25 mg.


RESULTS
Subjects exhibited a characteristic cardiac morphology, distinct from both concentric LVH (cLVH) and eccentric LVH (eLVH). Compared with normal controls, LV mass index was increased, end-diastolic volume index was increased, and ejection fraction was reduced, but sphericity indices did not differ. No significant changes were seen after spironolactone.


CONCLUSIONS
LVH in dialysis patients has a unique MRI appearance which is distinct from either cLVH or eLVH, with profound LV thickening and moderate dilation of the ventricular cavity. A 9-month course of spironolactone therapy did not affect morphology.
McGill
Rita L
RL
Division of Nephrology and Hypertension, Allegheny General Hospital, West Penn Allegheny Health System, Pittsburgh, Pennsylvania 15212-4772, USA. rmcgill@wpahs.org
Biederman
Robert W W
RW
Getts
Roger T
RT
Hazlett
Shawn M
SM
Sharma
Sandeep B
SB
Duran
Jonathan
J
Brandys
Dana E
DE
Sysak
Joshua C
JC
Sureshkumar
Kalathil K
KK
Sandroni
S E
SE
Marcus
R J
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D013148:Spironolactone / Q000627:therapeutic use
D013148:Spironolactone