Relative importance of aortic stiffness and volume as predictors of treatment-induced improvement in left ventricular mass index in dialysis

Panagiotis I. Georgianos, Rajiv Agarwal

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

This study aimed to explore the relative contribution of aortic stiffness and volume in treatment-induced change of left ventricular mass in dialysis. Hypertension in Hemodialysis Patients Treated with Atenolol or Lisinopril trial compared the effect of lisinopril versus atenolol in reducing left ventricular mass index; 179 patients with echo measurements of aortic pulse wave velocity and left ventricular mass at baseline were included. In unadjusted analysis, overall reductions of 26.24 g/m2 (95% CI: -49.20, -3.29) and 35.67 g/m2 (95% CI: -63.70, -7.64) in left ventricular mass index were noted from baseline to 6 and 12 months respectively. Volume control emerged as an important determinant of regression of left ventricular mass index due to the following reasons: (i) additional control for change in ambulatory systolic blood pressure mitigated the reduction in left ventricular mass index in the statistical model above [6-month visit: -18.6 g/m2 (95% CI: -43.7, 6.5); 12-month visit: -22.1 g/m2 (95% CI: -52.2, 8.0)] (ii) regression of left ventricular hypertrophy was primarily due to reduction in left ventricular chamber and not wall thickness and (iii) adjustment for inferior vena cava diameter (as a proxy for volume) removed the effect of time on left ventricular mass index reduction [6-month visit: -6.6 g/m2 (95% CI: (-41.6, 28.4); 12-month visit: 0.6 g/m2 (95% CI: -39.5, 40.7)]. In contrast, aortic pulse wave velocity was neither a determinant of baseline left ventricular mass index nor predictor of its reduction. Among dialysis patients, ambulatory systolic pressure, a proxy for volume expansion, but not aortic stiffness is more important predictor of reduction in left ventricular mass index. Improving blood pressure control via adequate volume management appears as an effective strategy to improve left ventricular hypertrophy in dialysis.

Original languageEnglish (US)
Article numbere0135457
JournalPLoS One
Volume10
Issue number9
DOIs
StatePublished - Sep 10 2015

Fingerprint

Vascular Stiffness
Dialysis
dialysis
Stiffness
Blood Pressure
Lisinopril
Pulse Wave Analysis
Atenolol
Left Ventricular Hypertrophy
Proxy
Blood pressure
Inferior Vena Cava
Statistical Models
Therapeutics
hypertrophy
Renal Dialysis
Pressure control
Hypertension
inferior vena cava
hemodialysis

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Relative importance of aortic stiffness and volume as predictors of treatment-induced improvement in left ventricular mass index in dialysis. / Georgianos, Panagiotis I.; Agarwal, Rajiv.

In: PLoS One, Vol. 10, No. 9, e0135457, 10.09.2015.

Research output: Contribution to journalArticle

@article{f9fba1a013ae48fea6c25b89c761c496,
title = "Relative importance of aortic stiffness and volume as predictors of treatment-induced improvement in left ventricular mass index in dialysis",
abstract = "This study aimed to explore the relative contribution of aortic stiffness and volume in treatment-induced change of left ventricular mass in dialysis. Hypertension in Hemodialysis Patients Treated with Atenolol or Lisinopril trial compared the effect of lisinopril versus atenolol in reducing left ventricular mass index; 179 patients with echo measurements of aortic pulse wave velocity and left ventricular mass at baseline were included. In unadjusted analysis, overall reductions of 26.24 g/m2 (95{\%} CI: -49.20, -3.29) and 35.67 g/m2 (95{\%} CI: -63.70, -7.64) in left ventricular mass index were noted from baseline to 6 and 12 months respectively. Volume control emerged as an important determinant of regression of left ventricular mass index due to the following reasons: (i) additional control for change in ambulatory systolic blood pressure mitigated the reduction in left ventricular mass index in the statistical model above [6-month visit: -18.6 g/m2 (95{\%} CI: -43.7, 6.5); 12-month visit: -22.1 g/m2 (95{\%} CI: -52.2, 8.0)] (ii) regression of left ventricular hypertrophy was primarily due to reduction in left ventricular chamber and not wall thickness and (iii) adjustment for inferior vena cava diameter (as a proxy for volume) removed the effect of time on left ventricular mass index reduction [6-month visit: -6.6 g/m2 (95{\%} CI: (-41.6, 28.4); 12-month visit: 0.6 g/m2 (95{\%} CI: -39.5, 40.7)]. In contrast, aortic pulse wave velocity was neither a determinant of baseline left ventricular mass index nor predictor of its reduction. Among dialysis patients, ambulatory systolic pressure, a proxy for volume expansion, but not aortic stiffness is more important predictor of reduction in left ventricular mass index. Improving blood pressure control via adequate volume management appears as an effective strategy to improve left ventricular hypertrophy in dialysis.",
author = "Georgianos, {Panagiotis I.} and Rajiv Agarwal",
year = "2015",
month = "9",
day = "10",
doi = "10.1371/journal.pone.0135457",
language = "English (US)",
volume = "10",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "9",

}

TY - JOUR

T1 - Relative importance of aortic stiffness and volume as predictors of treatment-induced improvement in left ventricular mass index in dialysis

AU - Georgianos, Panagiotis I.

AU - Agarwal, Rajiv

PY - 2015/9/10

Y1 - 2015/9/10

N2 - This study aimed to explore the relative contribution of aortic stiffness and volume in treatment-induced change of left ventricular mass in dialysis. Hypertension in Hemodialysis Patients Treated with Atenolol or Lisinopril trial compared the effect of lisinopril versus atenolol in reducing left ventricular mass index; 179 patients with echo measurements of aortic pulse wave velocity and left ventricular mass at baseline were included. In unadjusted analysis, overall reductions of 26.24 g/m2 (95% CI: -49.20, -3.29) and 35.67 g/m2 (95% CI: -63.70, -7.64) in left ventricular mass index were noted from baseline to 6 and 12 months respectively. Volume control emerged as an important determinant of regression of left ventricular mass index due to the following reasons: (i) additional control for change in ambulatory systolic blood pressure mitigated the reduction in left ventricular mass index in the statistical model above [6-month visit: -18.6 g/m2 (95% CI: -43.7, 6.5); 12-month visit: -22.1 g/m2 (95% CI: -52.2, 8.0)] (ii) regression of left ventricular hypertrophy was primarily due to reduction in left ventricular chamber and not wall thickness and (iii) adjustment for inferior vena cava diameter (as a proxy for volume) removed the effect of time on left ventricular mass index reduction [6-month visit: -6.6 g/m2 (95% CI: (-41.6, 28.4); 12-month visit: 0.6 g/m2 (95% CI: -39.5, 40.7)]. In contrast, aortic pulse wave velocity was neither a determinant of baseline left ventricular mass index nor predictor of its reduction. Among dialysis patients, ambulatory systolic pressure, a proxy for volume expansion, but not aortic stiffness is more important predictor of reduction in left ventricular mass index. Improving blood pressure control via adequate volume management appears as an effective strategy to improve left ventricular hypertrophy in dialysis.

AB - This study aimed to explore the relative contribution of aortic stiffness and volume in treatment-induced change of left ventricular mass in dialysis. Hypertension in Hemodialysis Patients Treated with Atenolol or Lisinopril trial compared the effect of lisinopril versus atenolol in reducing left ventricular mass index; 179 patients with echo measurements of aortic pulse wave velocity and left ventricular mass at baseline were included. In unadjusted analysis, overall reductions of 26.24 g/m2 (95% CI: -49.20, -3.29) and 35.67 g/m2 (95% CI: -63.70, -7.64) in left ventricular mass index were noted from baseline to 6 and 12 months respectively. Volume control emerged as an important determinant of regression of left ventricular mass index due to the following reasons: (i) additional control for change in ambulatory systolic blood pressure mitigated the reduction in left ventricular mass index in the statistical model above [6-month visit: -18.6 g/m2 (95% CI: -43.7, 6.5); 12-month visit: -22.1 g/m2 (95% CI: -52.2, 8.0)] (ii) regression of left ventricular hypertrophy was primarily due to reduction in left ventricular chamber and not wall thickness and (iii) adjustment for inferior vena cava diameter (as a proxy for volume) removed the effect of time on left ventricular mass index reduction [6-month visit: -6.6 g/m2 (95% CI: (-41.6, 28.4); 12-month visit: 0.6 g/m2 (95% CI: -39.5, 40.7)]. In contrast, aortic pulse wave velocity was neither a determinant of baseline left ventricular mass index nor predictor of its reduction. Among dialysis patients, ambulatory systolic pressure, a proxy for volume expansion, but not aortic stiffness is more important predictor of reduction in left ventricular mass index. Improving blood pressure control via adequate volume management appears as an effective strategy to improve left ventricular hypertrophy in dialysis.

UR - http://www.scopus.com/inward/record.url?scp=84944930089&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84944930089&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0135457

DO - 10.1371/journal.pone.0135457

M3 - Article

VL - 10

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 9

M1 - e0135457

ER -