Left ventricular hypertrophy and cardiac valve calcification and their impacts on survival in maintenance hemodialysis patients: A retrospective cohort study

The purpose of this article was to study the distribution of left ventricular hypertrophy (LVH) and cardiac valve calcification (CVC), relevant factors, and the relationship of LVH and CVC with survival in maintenance hemodialysis (MHD) patients. A total of 281 MHD patients were included in this retrospective and follow-up study. Echocardiography measurements were performed to evaluate the left ventricular structure and cardiac valve. Left ventricular mass (LVM), LVM index, relative wall thickness, and prevalence of LVH and CVC were calculated. Factors related to LVH and CVC and patients’ death risk were analyzed. The primary outcome was death. The prevalence of LVH in this study was 50.53% (142 patients). Concentric hypertrophy, concentric remodeling, and eccentric hypertrophy were found in 39.86%, 25.98%, and 10.68% of patients, respectively. Factors associated with LVH included systolic pressure, CVC, hemoglobin, and calcium carbonate in a multivariate logistic regression model (all P <.01). The log-rank χ 2 , which were 10.957, 12.668, 10.181, and 8.474 at 6, 12, 18, and 24 months follow-up, respectively, in the Kaplan–Meier model demonstrated the lower survival rates in patients with LVH than in those without (all P <.01). The prevalence of CVC was 60.14% (169 patients). Aortic valve calcification, mitral valve calcification, or both were found in 54.09%, 33.10%, and 27.05% of patients, respectively. In a multivariate logistic regression model, the factors associated with CVC were coronary heart disease, LVH, calcium, age, dialysis age, and diastolic pressure ( P <.05). In COX proportional hazard model, LVH resulted as an independent risk factor to all-cause death; the adjusted HR was 11.045, 4.382, 3.075, and 2.586 at 6, 12, 18, and 24 months follow-up, respectively (all P <.05). In MHD patients, LVH and CVC were highly prevalent, and LVH resulted as an independent risk factor for all-cause death.