Frequency of Left Ventricular Hypertrophy Among Patients on Maintenance Hemodialysis by Voltage Criteria and Its Relationship with Biophysical-Chemical Parameters

Alvina Zanib; Shahid Anwar; Khurram Saleem; Hafiz Muhammad Wasif Khan; Sana Zafar

doi:10.7759/cureus.7426

Frequency of Left Ventricular Hypertrophy Among Patients on Maintenance Hemodialysis by Voltage Criteria and Its Relationship with Biophysical-Chemical Parameters

Cureus. 2020 Mar 26;12(3):e7426. doi: 10.7759/cureus.7426.

Authors

Alvina Zanib¹, Shahid Anwar², Khurram Saleem³, Hafiz Muhammad Wasif Khan⁴, Sana Zafar³

Affiliations

¹ Internal Medicine, Fatima Jinnah Medical University, Lahore, PAK.
² Nephrology, Fatima Jinnah Medical University, Lahore, PAK.
³ Internal Medicine, University College of Medicine, University of Lahore, Lahore, PAK.
⁴ Internal Medicine, Fatima Jinnah Medical University, Sir Ganga Ram Hospital, Lahore, PAK.

Abstract

Background Among the dialysis population, left ventricular hypertrophy (LVH) is becoming a major cause of cardiovascular death, mainly due to myocardial infarction, heart failure, and arrhythmias. Electrocardiography (ECG) is a cheap and easily available test to detect the presence of left ventricular hypertrophy. The basic purpose of this study was to assess the frequency of left ventricular hypertrophy among the maintenance hemodialysis patients by applying different voltage criteria for the diagnosis of LVH and its relationship with various biophysical and biochemical parameters. Methods A total of 68 patients of end-stage renal disease (ESRD) were included in the study who were on maintenance hemodialysis at the dialysis center of Sughra Shafi Hospital. Baseline characteristics were recorded from the patients' data. Blood samples were drawn and electrocardiographs were taken, both before and after hemodialysis. Results Results showed variability in the detection of left ventricular hypertrophy in the pre- and post-dialysis period, as it was positive for 45%, 21%, and 17% in the pre-dialysis period versus 40%, 32%, and 25% in the post-dialysis period, when the Framingham, Sokolow-Lyon, and Cornell criteria were applied, respectively. The study showed a significant relationship between left ventricular hypertrophy with a high body mass index (BMI), hypertension, and pre- and post-dialysis hypomagnesemia (P <0.05). A significant association was also seen with low serum albumin levels over the past year. Conclusion According to this study, almost half of the dialysis patients were having left ventricle hypertrophy when Framingham criteria were applied. Good control of factors that are significantly associated with the occurrence of left ventricular hypertrophy can reduce morbidity and mortality among dialysis patients secondary to cardiovascular events. In this study, these factors included hypertension, hypomagnesemia, hypoalbuminemia, and high BMI.

Keywords: electrocardiogram (ecg); end stage renal disease (esrd); hemodialysis; left ventricular hypertrophy (lvh).