Key result
Echocardiography overestimated left ventricular mass and detected a higher prevalence of left ventricular hypertrophy (66.6% vs 36.7%) compared to cardiac magnetic resonance in hemodialysis patients.
Why the study?
Does echocardiography accurately measure left ventricular mass and detect left ventricular hypertrophy compared to cardiac magnetic resonance imaging in ESRD patients on hemodialysis?
Cross-Sectional (n=45)
No
Does echocardiography accurately measure left ventricular mass and detect left ventricular hypertrophy compared to cardiac magnetic resonance imaging in ESRD patients on hemodialysis?
Absolute Event Rate: 66.6% vs 36.7%
p-value: p=0.004
Echocardiography overestimates left ventricular mass and hypertrophy prevalence compared to CMR in hemodialysis patients, suggesting CMR is preferable for accurate assessment in this high-risk population.
Caution advised with echocardiography for left ventricular mass in hemodialysis; leaves open whether cardiac magnetic resonance should guide management.
BackgroundEnd-stage renal disease (ESRD) patients on hemodialysis (HD) are at increased risk for developing left ventricular hypertrophy (LVH), which is a predisposing factor for premature cardiovascular mortality. Although echocardiography (ECHO) has been the most commonly used technique for assessing LVH, cardiac magnetic resonance imaging (CMR) is now considered the gold standard and the most accurate tool for volume-independent determination of left ventricular mass (LVM).ObjectivesThis study aimed to evaluate the agreement in LVM measurement and LVH detection between CMR and ECHO.Patients and methodsA single-center, cross-sectional study including 30 ESRD patients on HD (group I) and 15, matched, healthy controls (group II) was performed to compare LVM measurement and LVH detection by ECHO and CMR.ResultIn both groups, ECHO overestimated LVM and left ventricular mass index (LVMI) in comparison with CMR. The Bland–Altman analysis demonstrated wider agreement limits (38.6 to −275.9 g) in LVM measurements by ECHO and CMR in group I (mean difference, 118.63 g, P≤0.001) than in group II (mean difference, 79.29 g; limits, −23.7 to −134.8 g, P≤0.001). Agreement was poor and not statistically significant in group I. Regarding LVMI measurement, there were wider agreement limits (145.5 to −18.8 g/m2) by ECHO and CMR in group I (mean difference, 63.33 g/m2, P≤0.001) than in group II (mean difference, 44 g/m2; limits, 71.3–16.7 g/m2, P≤0.001). Agreement was fair and statistically significant in group I. LVH prevalence by ECHO and CMR was 66.6 and 36.7%, respectively, in group I and 26.6 and 0%, respectively, in group II, with moderate agreement between both techniques (P=0.004) in group I.ConclusionECHO overestimates LVM and LVMI as well as LVH detection in comparison with CMR in ESRD patients on HD. Therefore, for accurate assessment of LVM, CMR may be a better option to detect LVH in this high cardiovascular risk group.
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Oraby et al. (2017) conducted a cross-sectional in End-stage renal disease on hemodialysis (n=45). Echocardiography vs. Cardiac magnetic resonance imaging was evaluated on Left ventricular hypertrophy (LVH) detection in ESRD patients (p=0.004). Echocardiography overestimated left ventricular mass and detected a higher prevalence of left ventricular hypertrophy (66.6% vs 36.7%) compared to cardiac magnetic resonance in hemodialysis patients.
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