Abstract: SA-PO402
Association of Changes in Vector Length with Changes in Right Ventricular Magnetic Resonance Imaging Indices among Patients on Maintenance Hemodialysis
Session Information
- Hemodialysis and Frequent Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Sayed, Enass, Harvard Medical School, Boston, Massachusetts, United States
- Chertow, Glenn M., Stanford University School of Medicine, Stanford, California, United States
- McCausland, Finnian R., Brigham and Women's Hospital, Boston, Massachusetts, United States
Background
Shorter vector length (a bioimpedance proxy of hypervolemia) is known to be associated with higher left ventricular volume indices among patients receiving maintenance hemodialysis (HD). However, the association of hypervolemia with right ventricular (RV) parameters is less clear.
Methods
Using data from the Frequent Hemodialysis Network Daily Trial (n=160), we used linear regression to assess the association of changes in vector length from baseline to month 12 with changes in magnetic resonance imaging (MRI) measures of RV parameters (RV end-diastolic volume (RVEDV), RV end-systolic volume (RVESV), RV stroke volume (RVSV), and RV ejection fraction (RVEF). We adjusted for baseline vector length, baseline outcome measurements, randomized treatment, age, sex, designated race, Quételet (body mass) index, access type, vintage (<2, 2-5, >5 years), pre-HD systolic BP, hypertension, heart failure, diabetes, residual urea clearance (0, ≤1, >1 to 3, >3 ml/min), hemoglobin, phosphate, ultrafiltration rate, angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) use, log-transformed erythropoietin dose, and eKt/V.
Results
The mean age was 50 ±13 years; 35% were female. In the fully adjusted models, a decline in vector length (per 50 Ω/m; i.e., a proxy for an increase in volume) was associated with an increase of 14.4 (95%CI 5.8, 23.0), 9.7 (95%CI 4.2, 15.2), and 4.7 (95%CI -0.6, 10.1) mL in RVEDV, RVESV, and RVSV, respectively; the relation between change in vector length an RVEF was curvilinear. Continuous associations are presented in restricted cubic splines (Figure 1).
Conclusion
Change in vector length over 12 months, a bioimpedance-derived proxy of volume status, was inversely associated with RVEDV and RVESV measured by cardiac MRI in patients randomized to conventional or frequent hemodialysis.
Association of change in vector length with changes in right ventricular volume
Funding
- NIDDK Support