Don Carleone Sanama B¹*, Aatif Taoufiq¹, Driss El Kabbaj¹, Fatimazahra Fikrat², Ilyasse Asfalou² and Aatif Benyass²

¹Department of Nephrology-Dialysis-Kidney Transplantation, Mohamed V Military Training Hospital, Rabat, Morocco
²Cardiology Center, Mohamed V Military Training Hospital, Rabat, Morocco

*Corresponding Author: Don Carleone Sanama B, Department of Nephrology-Dialysis-Kidney Transplantation, Mohamed V Military Training Hospital, Rabat, Morocco.

Received: December 06, 2021; Published: February 11, 2022

Abstract

Introduction: Cardiovascular complications are the leading cause of morbidity and mortality in hemodialysis. Left ventricular hypertrophy (LVH) is an independent factor of cardiovascular morbidity and mortality. Its frequency is 60 to 80% in chronic hemodialysis patients.

Objective: To determine the prevalence of LVH for more adequate cardiovascular management of our patients.

Methods: Observational and analytical cross-sectional study, carried out over a period of six months (February to July 2020), at the Hemodialysis Center of the HMIMV in Rabat. The study population consisted of chronic hemodialysis patients of both sexes, affiliated to the center, placed on conventional hemodialysis for more than three (3) months, and who had received pulsed and continuous Doppler echocardiography 2D. Demographic and clinical-biological data were collected from patient records, supplemented by questioning and listed on a pre-established operating sheet. LVH was defined as LV mass indexed to the body surface or LVMI (g/m2): ≥95 in women and ≥115 in men; The echocardiography was performed by the same operator, within 24 hours of the last dialysis session and data was collected via EchoPac software. The analysis was carried out with SPSS 20.0 software and written with Microsoft Office Word 2013.

Results: The size of our sample was 38 patients, of which 50% were men and 50% were women, for a sex ratio of 1. The mean age was 60.21 ± 16.864. The mean length of time on dialysis was 106.53 ± 72.72. Diabetic nephropathy was the most common in 31.6% of cases. Arterial hypertension was the 2nd CVRF present in 42.1% of cases. 94.7% were on AVF dialysis, and 71.1% had distal AVF. Predialytic hypertension was present in 57.9% of patients. The mean PPID was 4.55 ± 1.25. The mean dry weight was 65.73 ± 11.5. 8 patients (21.1%). The frequency of LVH was 31.6% with a female predominance. Concentric LVH was most common in 23.7% of cases; 36.8% had a concentric remodeling. The mean LVMI was 92.80 ± 28.87 with a maximum LVMI of 164.4 g/m2. 31.6% of patients had Hemoglobin <10 g/dl and the mean PRU was 72.94 ± 6.45.

Conclusion: LVH is very common in chronic hemodialysis patients. Its prevalence is 31.6% in our series. Its early diagnosis by 2D echocardiography must be done systematically. And its multidisciplinary management is important in order to reduce cardiovascular morbidity and mortality.

Keywords: Left Ventricular Hypertrophy (LVH); Hemodialysis; Cardiovascular Complications; HMIMV

References

1. Hassani K., et al. “Echocardiographic abnormalities in chronic end-stage renal failure Causes of death of dialysis patients: descriptive epidemiology 2001 / 2010 Bioethics Law 2004 and donation of life: the word to donors Urinary and hypert abnormalities”. 7.2011 (2020): 2010-2011.
2. Vircoulon M and Combe C. “Cardiac consequences of chronic renal failure”. 18.12 (2020): 1-14.
3. Taufiq Rohman S.Pd.I MP. “le Manuel du Résident”. Psikol Perkemb (2019): 1-224.
4. Suisse D and Finalement H. “Discovery of left ventricular hypertrophy on adult echocardiography”. Revue Médicale Suisse 13 (2017): 1106-1112.
5. Karimi I., et al. “Prevalence and predictive factors of occurrence of left ventricular hypertrophy in chronic hemodialysis Anxiodepressive disorders in chronic hemodialysis in eastern Morocco Ophthalmological manifestationss”. Nephrology Therapy5 (2013): 290.
6. Vigan J., et al. “Left ventricular hypertrophy in chronic hemodialysis patients at CNHU-HKM of Cotonou”. Nephrology Therapy1 (2018): 29-34.
7. Gosse P., et al. “Hypertrophie ventriculaire gauche au cours de l ’ hypertension artérielle”. EMC – Cardiology15 (2015): 1-11.
8. Havranek EP., et al. “Left Ventricular Hypertrophy and Cardiovascular Mortality by Race and Ethnicity”. The American Journal of Medicine 10 (2008): 870-875.
9. Glassock RJ., et al. “Left Ventricular Mass in Chronic Kidney Disease and ESRD”. 7 (2009): 79-91.
10. Chez É and Hd LH. “L’échocardiographie chez l’hémodialysé chronique”.
11. Malík J., et al. “Echocardiography in patients with chronic kidney diseases”. Cor Vasa3 (2018): e287-295.
12. Hedman K., et al. “Limitations of Electrocardiography for Detecting Left Ventricular Hypertrophy or Concentric Remodeling in Athletes”. The American Journal of Medicine 1 (2020): 123-132.e8.
13. Ezziani M., et al. “Echocardiographic abnormalities in chronic hemodialysis: Prevalence and risk factors”. Pan African Medical Journal 18 (2014): 1-6.
14. Raphael DM., et al. “Heart diseases and echocardiography in rural Tanzania: Occurrence, characteristics, and etiologies of underappreciated cardiac pathologies”. PLoS One12 (2018): 1-16.
15. Gerdts E., et al. “Left ventricular hypertrophy offsets the sex difference in cardiovascular risk (the Campania Salute Network)”. International Journal of Cardiology 258 (2018): 257-261.
16. Parfrey PS., et al. “Nephrology Dialysis Transplantation Outcome and risk factors for left ventricular disorders in chronic uraemia” (1996).
17. Faqih SA., et al. “Evaluation of Phosphocalcium, Nutritional, Cardiovascular and Complications Of Vascular Approach In Hemodialysis Over 20 Years”. Nephrology and Therapeutics5 (2015): 306.
18. Yildiz M., et al. “Left ventricular hypertrophy and hypertension”. Progress in Cardiovascular Diseases 1 (2020): 10-21.
19. McCullough PA., et al. “Intensive Hemodialysis, Left Ventricular Hypertrophy, and Cardiovascular Disease”. American Journal of Kidney Diseases 5 (2016): S5-14.

Citation

Citation: Don Carleone Sanama B., et al. Prevalence of Left Ventricular Hypertrophy in Chronic Hemodialysis Patients of Military Hospital Mohamed V in Rabat”.Acta Scientific Medical Sciences 6.3 (2022): 20-27.