title: Association between left ventricular mass index and cardiac function in pediatric dialysis patients.
abstract: BACKGROUND
  Left ventricular mass index (LVMI) is a surrogate of left ventricular hypertrophy and a predictor of cardiac morbidity and mortality in adults with hypertension. LVMI has not been linked to cardiovascular endpoints in children. The aim of this study was to identify an association between elevated LVMI and echocardiographic markers of systolic and diastolic function.
  
  
  METHODS
  The study was a retrospective review of chronic dialysis patients from June 1995 to December 2009 at a single tertiary care children's hospital. The upper limit cutoffs for LVMI were set at >38.6 g/m(2.7), >51 g/m(2.7), and by age and sex-based normative values. Sixty-three patients (mean age 14.1 years, 56% males) were enrolled in the study, with a total of 287 echocardiograms.
  
  
  RESULTS
  Post-dialysis hypertension was associated with elevated LVMI in both the >51 g/m(2.7) [odds ratio (OR) 2.9, 95% confidence interval (CI) 1.5-5.5] and normative (OR 3.4, 95% CI 1.5-7.7) models. Elevated LVMI, when defined by the >51 g/m(2.7) and normative models, was significantly associated with decreased shortening fraction (OR 4.1, 95% CI 1.7-9.8 and OR 5.4, 95% CI 1.3-22.9, respectively) and increased mitral E wave to lateral mitral tissue Doppler e' wave velocity ratio (E/e'; OR 3.5, 95% CI 1.1-11.2 and OR 4.5, 95% CI 1.0-21.6, respectively).
  
  
  CONCLUSIONS
  Elevated LVMI is associated with decreased systolic and diastolic cardiac function, justifying its use as a surrogate of hypertensive cardiomyopathy in children undergoing chronic dialysis.
authors: Department of Pediatrics, Lillie Frank Abercrombie Section of Cardiology, Baylor College of Medicine, 6621 Fannin St., MC-19345-C, Houston, 77030, TX, USA. shamszad@bcm.edu
authors: Pirouz
authors: P
authors: Shamszad
authors: Timothy C
authors: TC
authors: Slesnick
authors: E O'Brian
authors: EO
authors: Smith
authors: Michael D
authors: MD
authors: Taylor
authors: Daniel I
authors: DI
authors: Feig
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D004452:Echocardiography; D023381:Endpoint Determination; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging; D016017:Odds Ratio; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*