Periodic limb movements in sleep contribute to further cardiac structure abnormalities in hemodialysis patients with restless legs syndrome.
OBJECTIVE
In hemodialysis (HD) patients, restless legs syndrome (RLS) and periodic limb movements in sleep (PLMS) constitute common sleep disorders. Recent findings indicate a role for PLMS as a risk factor in the development of new or the aggravation of existing cardiovascular disease. The aim of the current study was to investigate the association of PLMS with indices of cardiac morphology and function in HD patients with RLS as a potential pathway by which PLMS could alter cardiovascular risk.


METHODS
Based on PLMS diagnosis by an overnight polysomnographic evaluation, 19 stable HD-RLS patients were divided into the PLMS group (n = 10) and the non-PLMS group (n = 9). During the overnight assessment, nocturnal blood pressure (BP) indices were also assessed. Left ventricular (LV) dimensions were examined by M-mode echocardiography, whereas LV diastolic function was evaluated by conventional Doppler and tissue Doppler imaging the following day.


RESULTS
LV internal diameter in diastole was significantly increased in the PLMS group (4.96 ± 0.61 vs 4.19 ± 0.48 cm, p = 0.007), leading to a significantly increase in LV mass (202 ± 52 vs 150 ± 37 g, p = 0.026). In contrast, no between group differences were observed in diastolic function indices (p > 0.05).


CONCLUSIONS
These are the first data to associate severe PLMS with further LV structure abnormalities in HD patients with RLS.
Department of Nephrology, School of Medicine, University of Thessaly, Larissa, Greece. giannaki@med.uth.gr
Christoforos D
CD
Giannaki
Paris
P
Zigoulis
Christina
C
Karatzaferi
Georgios M
GM
Hadjigeorgiou
Keith P
KP
George
Konstantinos
K
Gourgoulianis
Yiannis
Y
Koutedakis
Ioannis
I
Stefanidis
Giorgos K
GK
Sakkas
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001774:Blood Chemical Analysis; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D017286:Polysomnography; D011379:Prognosis; D012016:Reference Values; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015996:Survival Rate