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. 2009 Nov;39(11):488-93.
doi: 10.4070/kcj.2009.39.11.488. Epub 2009 Nov 30.

The association between left ventricular hypertrophy and biomarkers in patients on continuous ambulatory peritoneal dialysis

Sang-Ho Park  1 , Se-Whan Lee, Seung-Jin Lee, Won-Yong Shin, Dong-Kyu Jin, Hyo-Wook Gil, Jong-Oh Yang, Eun-Young Lee, Sae-Yong Hong
Affiliations

The association between left ventricular hypertrophy and biomarkers in patients on continuous ambulatory peritoneal dialysis

Sang-Ho Park et al. Korean Circ J. 2009 Nov.

Abstract

Background and objectives: Left ventricular hypertrophy (LVH) is a major cardiovascular complication and an important predictor of mortality in patients with end stage renal disease. Some studies have shown that the serum aldosterone levels are correlated with LVH in non-diabetic patients undergoing hemodialysis. The objective of this study was to elucidate the relationships between serum biomarkers, including aldosterone, and echocardiographic findings, such as LVH, in patients on peritoneal dialysis.

Subjects and methods: Thirty patients on continuous ambulatory peritoneal dialysis (CAPD) for >12 months at Soonchunhyang University Cheonan Hospital were included. Transthoracic echocardiography was performed and the left ventricular mass index (LVMI) was calculated using the Devereux formula. Serum biomarkers {N-terminal pro B-type natriuretic peptide (NT-proBNP), troponin T, C-reactive protein, renin, and aldosterone} were measured.

Results: Sixteen of 30 patients had LVH on the basis of the LVMI. The mean serum aldosterone level was 62.53+/-60.73 pg/mL (range, 5.03-250.68 pg/mL). LVH, on the basis of the LVMI, was not correlated with the serum aldosterone level. The serum aldosterone levels were not associated with echocardiographic findings, even with co-existing diabetes mellitus. The LVMI had a negative correlation with the hemoglobin (r=-0.405, p=0.029) and hematocrit (r=-0.374, p=0.042), and a positive correlation with NT-proBNP (r=0.560, p=0.002). The other biomarkers (renin, aldosterone, troponin T, and C-reactive protein) were not correlated with the LVMI. The LVMI was correlated with the left atrium volume index (r=0.675, p<0.001).

Conclusion: NT-proBNP is a good marker to predict LVH in patients undergoing CAPD. The serum aldosterone level is not correlated with LVMI, even with co-existing diabetes mellitus.

Keywords: Aldosterone; Left ventricular hypertrophy; Peritoneal dialysis; Type-B natriuretic peptide.

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Figures

Fig. 1
Fig. 1
Relationship of LVMI and aldosterone or NT-proBNP. A: there was no relationship between LVMI and aldosterone. B: there was relationship between LVMI and NT-proBNP (r=0.560, p=0.002). LVMI: left ventricular mass index, DM: diabetes mellitus, NT-ProBNP: N-terminal pro B-type natriuretic peptide.
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