Correlation between ankle brachial index, carotid intima media thickness and left ventricular hypertrophy in patients on maintenance hemodialysis

IntroductionLeft ventricular hypertrophy (LVH) is a major cardiovascular risk factor in patients on maintenance hemodialysis (HD). The aim of our study is to find correlation between ankle brachial index (ABI), carotid intima media thickness (IMT) and left ventricular hypertrophy in this population.Patient and methodsTwenty consecutive patients on maintenance hemodialysis were studied, all clinical data were included and laboratory data recorded, three most recent pre-dialysis blood pressure measurements were recorded and averaged. Ankle brachial index, also carotid intima media thickness were measured for all patients echocardiography to asses left ventricular wall thickness mainly was done.ResultsThere was positive correlation between IMT and LVH as well as a negative correlation between ABI and LVH in those patients on hemodialysis.Both parameters were correlated with BMI and serum albumin. When serum albumin level rise, ABI increase and IMT decrease indicating no atherosclerotic changes. Left ventricular mass index (LVMI) was also highly negatively correlated with serum albumin. Obesity was found to be associated with more atherosclerotic changes with rise of IMT and lowering of ABI in our work, but not correlated with LVMI. Systolic blood pressure (SBP) was also correlated with more atherosclerotic changes with higher IMT and lower ABI and positively correlated with LVH.ConclusionBoth ABI and carotid IMT are equally effective to predict cardiovascular risk as regard to LVH in hemodialysis population and ABI should be included as a bed side cheap and reliable way to assess cardiovascular risk in hemodialysis patients.