title: Relationships Between Left Ventricular Structure and Function According to Cardiac MRI and Cardiac Biomarkers in End-Stage Renal Disease.
abstract: We sought to assess the relationships between left ventricular (LV) remodelling and the mechanical and uremic stressors in hemodialysis patients.
  
  
  
  In this prospective 2-centre cohort study, 67 prevalent hemodialysis patients were followed for 1 year. Data on routine bloodwork and predialysis blood pressure (BP) measurements were collected over a 12-week period. LV end-diastolic volume (LVEDV) and LV mass (LVM) were measured using cardiac magnetic resonance imaging and indexed. High-sensitivity troponin-I (hsTnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), fibroblast growth factor 23 (FGF-23), and high-sensitivity C-reactive protein (hsCRP) were also measured. All study procedures were performed at baseline and at 1 year. We examined the relationships between LV remodelling and (1) NT-proBNP and hsTnI (LV stretch and injury); (2) ultrafiltration volume (UFV) and interdialytic weight gain (IDWT; volume overload); (3) predialysis BP measurements (pressure overload); and (4) biomarkers of inflammation (hsCRP) and fibrosis (FGF-23).
  
  
  
  LVEDV was significantly associated with UFV and with IDWT, at baseline as well as at 1 year. NT-proBNP was significantly and negatively correlated with UFV and IDWT, respectively, at 1 year. There were significant correlations between systolic BP and LVM index, at baseline and at 1 year as well as longitudinally. Systolic BP was the only parameter longitudinally correlated with LVM/LVEDV. hsTnI was not associated with urea, parathyroid hormone, calcium, phosphorus, FGF-23, hsCRP, or hemoglobin.
  
  
  
  We did not observe significant relationships between myocardial injury and markers of fibrosis, inflammation, and LV remodelling. Elevated predialysis systolic BP, which might represent a common mediator of pressure and volume overload, appears to be a dominant stimulus for LV remodelling.
authors.affiliation: Terrence Donnelly Heart Centre, St Michael's Hospital, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Ross
authors.affiliation: University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, St Michael's Hospital, and Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Ron
authors.initials: R
authors.lastname: Wald
authors.affiliation: University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, St Michael's Hospital, and Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Marc B
authors.initials: MB
authors.lastname: Goldstein
authors.affiliation: University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, St Michael's Hospital, and Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Darren A
authors.initials: DA
authors.lastname: Yuen
authors.affiliation: Department of Radiology and Division of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.affiliation: Division of Nephrology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Mercedeh
authors.initials: M
authors.lastname: Kiaii
authors.affiliation: Division of Nephrology, St Michael's Hospital, and Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rathe
authors.affiliation: University of Toronto, Toronto, Ontario, Canada; Department of Medical Imaging, St Michael's Hospital, Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Djeven P
authors.initials: DP
authors.lastname: Deva
authors.affiliation: University of Toronto, Toronto, Ontario, Canada; Department of Medical Imaging, St Michael's Hospital, Keenan Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Anish
authors.initials: A
authors.lastname: Kirpalani
authors.affiliation: Terrence Donnelly Heart Centre, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Olugbenga O
authors.initials: OO
authors.lastname: Bello
authors.affiliation: Terrence Donnelly Heart Centre, St Michael's Hospital, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
authors.forename: John J
authors.initials: JJ
authors.lastname: Graham
authors.affiliation: Terrence Donnelly Heart Centre, St Michael's Hospital, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
authors.forename: Howard
authors.initials: H
authors.lastname: Leong-Poi
authors.affiliation: Terrence Donnelly Heart Centre, St Michael's Hospital, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kim A
authors.initials: KA
authors.lastname: Connelly
authors.affiliation: Terrence Donnelly Heart Centre, St Michael's Hospital, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada. Electronic address: yana@smh.ca.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Yan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis; D013318:Stroke Volume; D013997:Time Factors; D019210:Troponin I / Q000097:blood; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23