Left ventricular mass and cardiothoracic index in patients with chronic renal disease on hemodialysis

J Bras Nefrol. 2014 Apr-Jun;36(2):171-5. doi: 10.5935/0101-2800.20140027.
[Article in English, Portuguese]

Abstract

Introduction: Left ventricular hypertrophy (LVH) is an independent predictor of cardiovascular risk in patients with chronic renal disease (CRD) on hemodialysis (HD).

Objective: To show the usefulness of chest radiography in the diagnosis of LVH in CRD patients on HD.

Methods: Cross-sectional study including 100 patients (58 men and 42 women), mean age 46.2 ± 14.0 years, with CRD of all causes, for at least six months on HD. Were obtained echocardiogram and chest x-rays of patients, always up to one hour after the end of HD sessions.

Results: LVH was detected in 83 patients (83%), of whom 56 (67.4%) had the concentric pattern and 27 (32.6%) with eccentric pattern of LVH. Cardiomegaly - defined by cardiothoracic index (CTI) > 0.5 - was present in 61 patients (61%). The following were the sensitivity, specificity and accuracy, respectively, for the variable ICT: 66.2%, 70.5% and 68.0%. The Pearson correlation between ICT and index of left ventricular mass (LVMI) was 0.552 (p < 0.05) and positive likelihood ratio of 2.2.

Conclusion: Chest radiography is a safe and useful as a diagnostic tool of LVH in CKD patients on HD.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / etiology*
  • Male
  • Middle Aged
  • Radiography, Thoracic
  • Renal Dialysis
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / therapy
  • Ultrasonography
  • Young Adult