title: Left ventricular mass in dialysis patients, determinants and relation with outcome. Results from the COnvective TRansport STudy (CONTRAST).
abstract: OBJECTIVE
  Left ventricular mass (LVM) is known to be related to overall and cardiovascular mortality in end stage kidney disease (ESKD) patients. The aims of the present study are 1) to determine whether LVM is associated with mortality and various cardiovascular events and 2) to identify determinants of LVM including biomarkers of inflammation and fibrosis.
  
  
  METHODS
  Analysis was performed with data of 327 ESKD patients, a subset from the CONvective TRAnsport STudy (CONTRAST). Echocardiography was performed at baseline. Cox regression analysis was used to assess the relation of LVM tertiles with clinical events. Multivariable linear regression models were used to identify factors associated with LVM.
  
  
  RESULTS
  Median age was 65 (IQR: 54-73) years, 203 (61%) were male and median LVM was 227 (IQR: 183-279) grams. The risk of all-cause mortality (hazard ratio (HR) = 1.73, 95% CI: 1.11-2.99), cardiovascular death (HR = 3.66, 95% CI: 1.35-10.05) and sudden death (HR = 13.06; 95% CI: 6.60-107) was increased in the highest tertile (>260 grams) of LVM. In the multivariable analysis positive relations with LVM were found for male gender (B = 38.8±10.3), residual renal function (B = 17.9±8.0), phosphate binder therapy (B = 16.9±8.5), and an inverse relation for a previous kidney transplantation (B = -41.1±7.6) and albumin (B = -2.9±1.1). Interleukin-6 (Il-6), high-sensitivity C-reactive protein (hsCRP), hepcidin-25 and connective tissue growth factor (CTGF) were not related to LVM.
  
  
  CONCLUSIONS
  We confirm the relation between a high LVM and outcome and expand the evidence for increased risk of sudden death. No relationship was found between LVM and markers of inflammation and fibrosis.
  
  
  BACKGROUND
  Controlled-Trials.com ISRCTN38365125.
authors: Department of Nephrology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors: Ira M
authors: IM
authors: Mostovaya
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
authors: Michiel L
authors: ML
authors: Bots
authors: Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands.
authors: Marinus A
authors: MA
authors: van den Dorpel
authors: Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors: Roel
authors: R
authors: Goldschmeding
authors: Department of Nephrology, University Medical Center Utrecht, Utrecht, the Netherlands ; Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands.
authors: Claire H
authors: CH
authors: den Hoedt
authors: Department of Cardiology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands.
authors: Otto
authors: O
authors: Kamp
authors: Department of Nephrology, Centre Hospitalier de l'Université de Montréal St. Luc Hospital, Montréal, Canada.
authors: Renée
authors: R
authors: Levesque
authors: Department of Nephrology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors: Albert H A
authors: AH
authors: Mazairac
authors: Department of Nephrology, University Medical Center Utrecht, Utrecht, the Netherlands ; Department of Nephrology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands.
authors: E Lars
authors: EL
authors: Penne
authors: Department of Laboratory Medicine, Laboratory of Genetic, Endocrine and Metabolic diseases, Radboud University Medical Centre Nijmegen, the Netherlands.
authors: Dorine W
authors: DW
authors: Swinkels
authors: Department of Nephrology, University Medical Center Utrecht, Utrecht, the Netherlands ; Department of Nephrology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands.
authors: Neelke C
authors: NC
authors: van der Weerd
authors: Department of Nephrology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands ; Institute for Cardiovascular Research Vrije Universiteit Medical Center, Vrije Universiteit Medical Center, Amsterdam, the Netherlands.
authors: Piet M
authors: PM
authors: Ter Wee
authors: Department of Nephrology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands ; Institute for Cardiovascular Research Vrije Universiteit Medical Center, Vrije Universiteit Medical Center, Amsterdam, the Netherlands.
authors: Menso J
authors: MJ
authors: Nubé
authors: Department of Nephrology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors: Peter J
authors: PJ
authors: Blankestijn
authors: Department of Nephrology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands ; Institute for Cardiovascular Research Vrije Universiteit Medical Center, Vrije Universiteit Medical Center, Amsterdam, the Netherlands.
authors: Muriel P C
authors: MP
authors: Grooteman
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D006435:Renal Dialysis; D014463:Ultrasonography; D016277:Ventricular Function, Left