Probing Dry-Weight Improves Left Ventricular Mass Index

被引:36
作者
Agarwal, Rajiv [1 ]
Bouldin, J. Michael
Light, Robert P.
Garg, Ashok [2 ]
机构
[1] Richard L Roudebush VA Med Ctr, Indianapolis, IN USA
[2] Arizona Heart & Arrythmia Clin, Phoenix, AZ USA
基金
美国国家卫生研究院;
关键词
Hemodialysis; Hypertension; Ultrafiltration; Ambulatory blood pressure; Volume overload; Echocardiogram; Left ventricular hypertrophy; Left ventricular systolic function; DIALYZED UREMIC PATIENTS; HEMODIALYSIS-PATIENTS; PROLONGED THERAPY; ACE-INHIBITORS; RENAL-DISEASE; HYPERTROPHY; REGRESSION; IMPACT; TRIAL; INTERVENTION;
D O I
10.1159/000326235
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Although probing dry-weight improves blood pressure control, its effect on echocardiographic left ventricular mass index (LVMI) is unknown. Methods: Shortly following dialysis, 292 echocardiograms in 150 patients participating in the DRIP trial were obtained at baseline and longitudinally every 4 weeks on 2 occasions. Results: At baseline, LVMI was 136.3 g/m(2) in the control group and 138.7 g/m(2) in the ultrafiltration group (p > 0.2 for difference). The change from baseline in LVMI in the control group was +3.5 g/m(2) at 4 weeks and +0.3 g/m(2) at 8 weeks (p 1 0.2 for both changes). The change from baseline in LVMI in the ultrafiltration group was -7.4 g/m(2) at 4 weeks (p = 0.005) and -6.3 g/m(2) at 8 weeks (p = 0.045). With ultrafiltration, the change in LVMI diameter was -10.9 g/m(2) more compared to the control group at 4 weeks (p = 0.012) and -6.6 g/m(2) more compared to the control group at 8 weeks (p = 0.21). The reduction in interdialytic ambulatory blood pressure was also greater in response to probing dry-weight in those in the top half of LVMI at baseline (p = 0.02 for interaction effect at week 8). Conclusion: LVMI, an important determinant of prognosis among long-term dialysis patients, is responsive to probing dry-weight. Copyright (C) 2011 S. Karger AG, Basel
引用
收藏
页码:373 / 380
页数:8
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