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Open Access Highly Accessed Research article

Left atrial volume index and aortic stiffness index in adult hemodialysed patients - link between compliance and pressure mediated by endothelium dysfunction; a cross-sectional study

Tomasz Zapolski1*, Andrzej Wysokiński1, Andrzej Książek2 and Andrzej Jaroszyński3

Author Affiliations

1 Chair and Department of Cardiology, Medical University of Lublin, Lublin, Poland

2 Chair and Department of Nephrology, Medical University of Lublin, Lublin, Poland

3 Chair and Department of Family Medicine, Medical University of Lublin, Lublin, Poland

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BMC Cardiovascular Disorders 2012, 12:100  doi:10.1186/1471-2261-12-100

Published: 5 November 2012

Abstract

Background

This study was performed to investigate the relationship between elastic properties of aorta and left atrium volume index (LAVI) in hemodialyzed (HD) patients.

Methods

Study group was consisted of 73 patients (age 51,6 ± 7,6 years) treated by hemodialysis. In all patients standard echocardiography was performed. Aortic stiffness index (ASI) was calculated using formula: ASI = log (SBP/DBP)/[(Aomax-Aomin)/Aomin]. LAVI was calculated according to the formula: LAVI = [π/6 x (LAmax x LAshort x LAlong)]/m2. Additionally several indices were calculated: left ventricle mass (LVM), left ventricle mass index (LVMI), midwall fractional shortening (mFS), endsystolic stress (ESS), mFS/ESS. Additionally the laboratory parameters including lipidogram, troponin T (cTnT), NT-proBNP and asymmetric dimethylarginine (ADMA) were measured.

Results

The ASI was strong and significantly correlated with left atrium volume (LAV) and LAVI (respectively: 0,601; p < 0,001 and 0,598; p < 0,001). The ASI was independently and markedly associated with ADMA, cTnT, CRP, T-chol, and LDL-chol. The LAVI was independently and significantly correlated with NT-proBNP and cTnT.

Conclusions

There is correlation between ASI and ADMA, marker of endothelium dysfunction. There is also association between LAVI and NT-proBNP, signs of elevated left atrium pressure. The strong correlation between ASI and LAVI, improved by associations of specific biochemical markers with these echocardiographic indices, suggests there is the link between elastic properties of aorta and left atrium pressure in hemodialysed patients mediated by endothelial dysfunction.

Keywords:
Left atrium volume index; Aortic stiffness; NT-pro BNP; Asymmetric dimethylarginine; End-stage renal disease; Hemodialysis