Background: early diagnosis of LEFT VENTRICULAR mass (LVM) inappropriateness and LEFT VENTRICULAR HYPERTROPHY (LVH) can result in preventing diastolic LEFT VENTRICULAR dysfunction and its related morbidity and mortality. This study was performed to determine if diastolic dysfunction is associated with LVH and inappropriate LVM.Materials and Methods: one hundred and twenty five uncomplicated hypertension from Isfahan Healthy Heart Program underwent two-dimensional echocardiography. Inappropriate LVM was defined as an LVM index greater than 88 g/m2 of body-surface area in women and greater than 102 g/m2 in men. LVH-defined septal and posterior wall thickness greater than 0/9 cm in women and greater than 1 cm in men, respectively. Echocardiographic parameters, including early diastolic peak velocity (E) /late diastolic peak velocity (A), deceleration time (DT), and E/early mitral annulus velocity (E') were measured.Results: the mean systolic and diastolic blood pressure at the patients’ admission day were 142.87 ± 18.12 and 88.45 ± 9.18 mmHg, respectively. Totally, 21.7% of subjects had inappropriate LV mass that moderate and severe abnormal LV mass was revealed in 5.6% and 5.6%, respectively. The mean of age and BMI was significantly higher in patients with moderate LEFT VENTRICULAR HYPERTROPHY (P<0.05). Adjusted by age, gender, BMI, and systolic and diastolic blood pressures, both E/A ratio and deceleration time were higher in those with the severer VENTRICULAR HYPERTROPHY. Subjects with severe showed significantly higher BMI 33.7 ± 3.7 (P< 0.001). There was a slight difference between the grade of diastolic dysfunction and the severity of inappropriate LV mass (P=0.065). But no significant difference was found between E/A, E/E', and deceleration time and the level of inappropriate LV mass (P>0.05). Spearman’s Rank test was used to test the correlation between diastolic dysfunction and LV mass (P=0.025).Conclusion: LVH is correlated with the severity of diastolic dysfunction manifested by the E/A value and deceleration time, but inappropriate LVM can slightly predict diastolic dysfunction severity in uncomplicated hypertension.

Background: Cardiovascular disease (CVD) is one of the leading causes of mortality among kidney transplant (KTx) recipients. LEFT VENTRICULAR HYPERTROPHY (LVH) is a known important risk factor for CVD in KTx recipients. The current study aimed at evaluating the association of LVH with hypertension, carotid intima media thickness (CIMT), and serum biomarkers. Methods: The current cross sectional study included KTx recipients; ambulatory blood pressure monitoring, echocardiography, and CIMT measurement were performed. In addition to standard laboratory investigations, high sensitivity C-reactive protein (CRP) and serum homocysteine were measured. Results: A total of 30 KTx recipients (20 male, 10 female, mean age: 44. 53 13. 59 years) were enrolled. One-third had diabetes and 73. 3% hypertension. Their mean systolic and diastolic blood pressure (BP) was 132. 0 14. 4 and 77. 8 11. 3mmHg, respectively. BP was well controlled, albeit with more antihypertensive agents of 1. 5 (interquartile range (IQR): 0-4). Their baseline serum creatinine and eGFR were 108. 3 (IQR: 66-319)  M/L and 69. 8  20. 8 mL/min/1. 73 m2, respectively. Seven patients had LVH and predominantly had diabetes, a higher pulse pressure, and elevated serum homocysteine. Predictors of LEFT VENTRICULAR mass index (LVMI) were the incidence of diabetes, higher pulse pressure, serum homocysteine, and the number of antihypertensive agents prescribed. On multivariate analysis, diabetes and pulse pressure were the main predictors of LEFT VENTRICULAR mass index. Conclusions: LVH is common in patients with KTx, especially in the ones with diabetes. Serum homocysteine is a surrogate marker for LVH.

Introduction: The aim of this study was to evaluate VENTRICULAR geometry, its relationship with the inflammatory markers, and mortality of patients with end-stage renal disease on peritoneal and hemodialysis treatment.Materials and Methods: We enrolled adult patients on long-term dialysis (hemodialysis and peritoneal dialysis) for more than 3 months. Two-dimensional echocardiography was performed by an experienced cardiologist who was blinded to all clinical details of patients. Cardiovascular mortality was assessed during a 2-year follow-up period.Results: There were 129 participants, of whom 86 (66%) were on hemodialysis. LEFT VENTRICULAR HYPERTROPHY was present in 86.7%; concentric HYPERTROPHY was found in 64 (49.1%) and eccentric HYPERTROPHY in 48 patients (37.2%). Patients with LEFT VENTRICULAR HYPERTROPHY were further divided into tertiles according to their LEFT VENTRICULAR mass index. Logistic regression found pulse pressure as an independent risk factor associated with LEFT VENTRICULAR mass index (odds ratio [OR], 1.04; 95% confidence interval (CI), 1.01 to 1.19; P=.047). Cardiovascular mortality rate was 15.5%.Multivariable analysis showed that C-reactive protein (OR, 1.06; 95% CI, 1.01 to 1.10; P=.01), pulse pressure (OR, 1.01; 95% CI, 1.0 to 1.26; P=.046), and LEFT VENTRICULAR mass index (OR, 1.03; 95% CI, 1.01 to 1.21; P=.03) were independent risk factors for cardiovascular mortality.Conclusions: Concentric HYPERTROPHY is the most frequent LEFT VENTRICULAR geometry model in patients with chronic kidney disease.Inflammation, pulse pressure, and LEFT VENTRICULAR HYPERTROPHY are interrelated and all contribute to mortality and cardiovascular death risk among dialysis patients.