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Abstract: FR-PO353

Prognostic Value of Left Atrial Volume Index (LAVi) in ESRD Patients

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Sarwar, Shahbaz, DHMC, Lahore, Pakistan
  • Saleem, Sidra, DHMC, Lahore, Pakistan
  • Naveed, Haris, DHMC, Lahore, Pakistan
  • Ittifaq, Afshan, DHMC, Lahore, Pakistan
  • Mahmood, Asad, DHMC, Lahore, Pakistan
  • Mansur, Abeera, DHMC, Lahore, Pakistan
Background

Cardiovascular Disease is the leading cause of death in End Stage Renal Disease (ESRD) patients. Echocardiographic estimation reveals that left atrial volume Index (LAVi) is increased in diastolic dysfunction of left ventricle, hypertensive heart disease and chronic kidney disease patients. LAVi is an established independent risk predictor for mortality in atherosclerotic heart disease. However, LAVi has not been extensively studied in ESRD population. The aim of this study is to assess the impact of LAVi on cardiovascular mortality in hemodialysis patients.

Methods

From January 1, 2013, through April 30, 2018, we evaluated echocardiographic findings of 91 ESRD patients on maintenance hemodialysis. LAVi was categorized as 1 and 2 (1 < 40 mL/m2 and 2 ≥40 mL/m2 ). All patients had an ejection fraction of greater than 40%. Patient information was collected and data analysed using SPSS version 22 for windows software package.

Results

Out of 91 patients, 34 patients(37.4%) had LAVi greater than 40 ml/m2. Among 34 patients with LAVi greater than 40ml/m2, 64.7% encountered death. The proportion of death was significantly more in LAVi group 2 than in LAVi group 1 (P=0.007). Unadjusted logistic regression analysis revealed that cardiovascular mortality in LAVi group 2 was 3.4 times higher as compared to LAVi 1 (OR=3.39; 95%CI: 1.39-8.25).
In survival analysis the patients with increased LAVi (group 2) were at a greater risk of mortality. Although this group also showed an observable difference in survival and a hazard ratio of 1.5 it was not significant(p=0.197).

Conclusion

Increased LAVI is an independent predictor of cardiovascular mortality in End Stage Renal Disease patients.

Alive
Number of deaths
Crude OR (95%CI)
P ValueAdjusted OR (95%CI)
P Value
Lavi GroupGroupNumberPercentageNumberPercentage
13764.9%2035.1%3.39
(1.39-8.25)
0.0073.72
(1.44-9.58)
0.006
21235.3%2264.7%