Abstract: FR-PO466
Plasma Fibrinogen: A Driver of Left Ventricular Remodeling in Peritoneal Dialysis Patients and Its Related Risk Factors
Session Information
- Peritoneal Dialysis: Current Topics
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Chen, Yun, Huashan Hospital Fudan University, Shanghai, Shanghai, China
- Hao, Chuanming, Huashan Hospital Fudan University, Shanghai, Shanghai, China
- Zhu, Tongying, Huashan Hospital Fudan University, Shanghai, Shanghai, China
Background
Plasma fibrinogen (FIB) has been recently proven to be significantly associated with an increased risk of cardiovascular events and all-cause mortality in patients undergoing peritoneal dialysis (PD). Left ventricular hypertrophy (LVH) is common among PD patients. However, the relationship between the plasma FIB and the LV remodeling in PD patients was rarely discussed. The study aimed to investigate the role of plasma FIB in LV remodeling and LV functions in patients on PD, and explore risks factors related to plasma FIB level.
Methods
Patients with echocardiography for three consecutive years were recruited between Dec. 2010 and May 2020. Echocardiographic measurements of LV geometry and LV function were collected and LVH-progression was evaluated. Correlation analysis was performed to explore the plasma FIB level and LV geometry and LV function. Pathogenic factors correlated to the LVH-progression were explored by logistic regression models and the role of FIB in it was verified by receiver operating characteristic (ROC) curve analysis. Linear regression models were conducted to identify factors associated with plasma FIB level.
Results
A total of 268 PD patients (96 males, 57.8%) were recruited with an average age of 55.9 ± 16.5 years.Patients were trisected according to plasma FIB level. Patients in the third tertile (with higher FIB level) had higher mean wall thickness (MWT), relative wall thickness (RWT) and left ventricular mass index (LVMI) and lower E/A ratio than those in the other tertiles. 112 patients were detected to have LVH progression. Multivariable logistic regression showed that plasma FIB level was an independent risk factor for LVH-progression (OR, 1.591; 95% CI, 1.243–2.037; p <0.001). And the ROC analysis indicated that the area under the curve (AUC) of fibrinogen level for predicting LVH-progression was 0.637 (p<0.001). Multiple linear regression analysis identified history of diabetes, age, PD duration, CRP and ApoB were risk factors for a higher plasma FIB level in PD patients.
Conclusion
An elevated plasma FIB level was independently associated with LVH-progression and significantly related to declined LV function in patients undergoing PD. History of diabetes, age, PD duration, CRP and ApoB were risk factors for a high level of plasma FIB. Plasma FIB might be a valuable marker for LV-remodeling monitoring.