Analysis of factors influencing the left ventricular mass in chronic hemodialysis patients

Incidences of cardiovascular diseases are increased in hemodialysis patients, and the existence of left ventricular hypertrophy is one of the major risk factors for cardiovascular events. The purpose of this study is to elucidate the factors contributing to the development of left ventricular hypertrophy in hemodialysis patients. Left ventricular mass index (LVMI) on echocardiography was measured in 166 chronic hemodialysis patients (80 men, 86 women, age 56±1 years) without ischemic or valvular heart disease, and the correlations with physical and laboratory findings including the renin-angiotensin system were analyzed. Among the physical findings, systolic and diastolic blood pressure strongly correlated with LVMI (r=0.254 and r=0.261, respectively, p=0.001). Factors such as age, duration of dialysis, cause of renal failure and inter-dialysis weight gain did not significantly correlate with LVMI. Regarding laboratory data, plasma angiotensin II (A II) showed positive correlation with LVMI (r=0.184, p=0.02). However, insertion/deletion (I/D) polymorphism of ACE gene did not significantly affect LVMI (II 152±7, ID 151±6, DD 142±9g/m2), and plasma A II was not significantly different between the genotypes (II 15.8±2.8, ID 12.4±1.5, DD 14.8±3.1pg/mL). It is suggested that blood pressure is an important factor contributing to the increase in LVMI in chronic hemodialysis patients and that activation of the renin-angiotensin system may participate in the development of left ventricular hypertrophy.