In CKD patients, left ventricular mass was significantly greater than controls (93 ± 16 g vs 76 ± 18 g, P < 0.01), correlated with MSNA despite antihypertensive treatment.
Does sympathetic activity correlate with left ventricular mass in CKD patients despite standard antihypertensive treatment?
Sympathetic nerve activity assessed years prior positively correlates with left ventricular mass in CKD patients despite well-controlled blood pressure on standard ACEi/ARB therapy.
The period between MSNA and MRI measurements was 9 ± 3 years. All patients were treated according to guidelines with an ACEi or an ARB. In CKD patients, mean systolic and diastolic arterial pressure were 129 ± 10 and 84 ± 5 mmHg, respectively, during follow-up. In patients, as compared to controls, LVM was 93 ± 16 versus 76 ± 18 g, LVM index 30 ± 5 versus 24 ± 4 g/m(2.7) and mean wall thickness 11 ± 2 versus 9.0 ± 1 mm (all P < 0.01). Moreover, MSNA was related to LVM (r = 0.65, P < 0.002), LVM index (r = 0.46, P < 0.03) and LV mean wall thickness (r = 0.84, P < 0.001). Conclusions. In conclusion, the present study demonstrates that measures of LVM in CKD patients are greater than in healthy controls, despite a well-controlled blood pressure in the patients. Moreover, there is a positive relationship between these measures of LVM and MSNA, assessed years before, despite a standard antihypertensive treatment. These results support the notion that additional sympatholytic therapy could be beneficial.
Siddiqi et al. (2010) studied this question. In CKD patients, left ventricular mass was significantly greater than controls (93 ± 16 g vs 76 ± 18 g, P < 0.01), correlated with MSNA despite antihypertensive treatment.