Left ventricular mass may help predict future cardiovascular and renal outcomes: Study

Data presented today at the American Society of Hypertension, Inc.'s 25th Annual Scientific Meeting and Exposition (ASH 2010) indicate that in men with high cardiovascular risk, left ventricular mass may help better predict future cardiovascular and renal outcomes, including hemodialysis.

Left ventricular hypertrophy (LVH) is becoming exceedingly common in patients with renal dysfunction, and reducing the incidence of end-stage renal disease is widely recognized as a major public health goal given the adverse social and economic costs of hemodialysis. Additionally, a substantial amount of evidence has documented a strong association between impaired kidney function and adverse cardiovascular events, including myocardial infarction and stroke.

In this retrospective study evaluating more than 6,000 men (mean age 68 years, the majority being hypertensive) for a period of 14 years, investigators assessed left ventricular mass index (LVMI) at baseline, and kidney function and blood pressure levels both at baseline and at the end of the follow-up period.

A strong association of LVMI for both body surface area and height on all of the examined renal outcomes (i.e. doubling of serum creatinine, retreating of glomerular filtration rate below 30mL/min/1.73m2 and incident hemodialysis) was observed. For each 42 g/m2 increase in LVMI there was a rise in the risk of all renal outcomes by: 45.7 percent for doubling of serum creatinine; 51.9 percent for estimated glomerular filtration rate < 30 mL/min/1.73m2; and 58.3 percent for hemodialysis. Moreover, patients with at least moderate grade LVH (left ventricular mass index more than 125g/m2) showed a marked decline of kidney function when compared with those without (left ventricular mass index below 110gr/m2).

"In men with high cardiovascular risk, the severity of LVH could be a useful clinical tool in determining the decline of kidney function, including the increased probability for hemodialysis," said study author, Costas Tsioufis, M. D., professor of medicine, Cardiology Department, Veterans Affairs Medical Center, Washington, D.C. "These results underline that at least moderate cardiac hypertrophy substantially accelerates the development of adverse renal outcomes, further suggesting that minor degrees of hypertrophy could constitute the appropriate time period to act for protecting kidneys from progressive impairment."