Change of Left Ventricular Function in CAPD Patients

連續可活動性腹膜透析病人左心室功能的變化

蔡明峰(Ming-Feng Tsai) ； 陳鴻鈞(Hung-Chun Chen) ； 顧進裕(Jinn-Yuh Guh) ； 邱怡文(Yi-Wen Chiu) ； 蕭彬吾(Rin-Wu Hsiao) ； 賴永勳(Yung-Hsiung Lai)

《Acta Nephrologica》 14卷4期 (2000/10) Pp. 267-267

並列摘要

Left ventricular hypertrophy (LVH) is present in over 70% of patients commencing dialysis. It is also an independent risk factor for cardiac death, which accounts for approximately 45% of death in dialysis patients. In present study, we have evaluated the effect of CAPD therapy on left ventricular function. The patients consisted of 17 men and 24 women (mean age 45 years). Initially, LVH was present in 65.8% of all patients by echocardiography. The patients were further divded into LVH group (27 patients) and non-LVH group (14 patients). After follow up for 18 months, abnormal LV diastolic function decreased from 80.5% (33 patients) to 70.7% (29 patients) and the prevalence of LVH decreased from 65.8% to 58.5% in all 41CAPD patients. The prevalence of pericardial effusion (17.1%) and asymmetrical septal hytpertrophy (12%) were also not changed. In LVH group, all the thickness of interventricular septum (13.3±3.0 vs. 12.0±2.7mm), LV end-systolic diameter (34.6±9.9 vs. 32.0±8.6 mm) and LV muscle mass index decreased significantly (all P＜0.05) after follow up. Increased Hb, Hct and PTH level (all P＜0.05) were also noted in LVH group. RV diameter and albumin level decreased significantly in non-LVH group. Reserved A/E (A: peak atrial filing velocity; E: peak early diastolic flow velocity) was noted in 70.3% of LVH and 71.4% of non-LVH patients, respectively after follow up. Our results indicate that in patients on CCAPD, the prevalence of diastolic LV dysfunction is high whether the LVH is present ont. CAPD therapy may regress LVH by decreasing IVS, which may be related to the partial correction of anemia.