Pediatric Nephrology

, Volume 27, Issue 5, pp 835–841

Association between left ventricular mass index and cardiac function in pediatric dialysis patients

  • Pirouz Shamszad
  • Timothy C. Slesnick
  • E. O’Brian Smith
  • Michael D. Taylor
  • Daniel I. Feig
Original Article

Abstract

Background

Left ventricular mass index (LVMI) is a surrogate of left ventricular hypertrophy and a predictor of cardiac morbidity and mortality in adults with hypertension. LVMI has not been linked to cardiovascular endpoints in children. The aim of this study was to identify an association between elevated LVMI and echocardiographic markers of systolic and diastolic function.

Methods

The study was a retrospective review of chronic dialysis patients from June 1995 to December 2009 at a single tertiary care children’s hospital. The upper limit cutoffs for LVMI were set at >38.6 g/m2.7, >51 g/m2.7, and by age and sex-based normative values. Sixty-three patients (mean age 14.1 years, 56% males) were enrolled in the study, with a total of 287 echocardiograms.

Results

Post-dialysis hypertension was associated with elevated LVMI in both the >51 g/m2.7 [odds ratio (OR) 2.9, 95% confidence interval (CI) 1.5–5.5] and normative (OR 3.4, 95% CI 1.5–7.7) models. Elevated LVMI, when defined by the >51 g/m2.7 and normative models, was significantly associated with decreased shortening fraction (OR 4.1, 95% CI 1.7–9.8 and OR 5.4, 95% CI 1.3–22.9, respectively) and increased mitral E wave to lateral mitral tissue Doppler e′ wave velocity ratio (E/e′; OR 3.5, 95% CI 1.1–11.2 and OR 4.5, 95% CI 1.0–21.6, respectively).

Conclusions

Elevated LVMI is associated with decreased systolic and diastolic cardiac function, justifying its use as a surrogate of hypertensive cardiomyopathy in children undergoing chronic dialysis.

Keywords

Left ventricular mass index Dialysis Hypertension Diastolic dysfunction Systolic dysfunction 

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Copyright information

© IPNA 2011

Authors and Affiliations

  • Pirouz Shamszad
    • 1
  • Timothy C. Slesnick
    • 2
  • E. O’Brian Smith
    • 3
  • Michael D. Taylor
    • 4
  • Daniel I. Feig
    • 5
  1. 1.Department of Pediatrics, Lillie Frank Abercrombie Section of CardiologyBaylor College of MedicineHoustonUSA
  2. 2.Department of Pediatrics, Sibley Heart Center CardiologyEmory University School of MedicineAtlantaGeorgia
  3. 3.Department of Pediatrics, Children’s Nutrition Research CenterBaylor College of MedicineHoustonUSA
  4. 4.Department of Pediatrics, Section of Cardiology, The Heart InstituteCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  5. 5.Department of Pediatrics, Division of NephrologyUniversity of Alabama, BirminghamBirminghamUSA

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