Abstract 15228: Echocardiographic Abnormalities in Dialysis Patients Who Suffer Sudden Cardiac Arrest
Introduction: Severely reduced kidney function and dialysis are associated with a significantly increased risk of sudden cardiac arrest (SCA), but predisposing factors are not fully understood. We compared echocardiographic parameters in dialysis patients with SCA to all other cases of SCA occurring in a large community.
Methods: All SCA cases were prospectively ascertained during a 13-year period in a Northwestern US metro region, and full demographic and clinical data including archived echocardiogram reports were collected from the lifetime medical records. Demographic and echocardiographic characteristics of 63 dialysis patients with SCA were compared to 427 non-dialysis SCA subjects from the general population.
Results: Dialysis patients with SCA were over 6 years younger (62.8 ± 11.5 vs 69.3 ± 14.0 yrs, p<0.001) than other SCA cases, with a significantly larger proportion of African Americans (33.3% vs 8.7%, p<0.001). Diabetes (79.4% vs 43.8%, p<0.001) and hypertension (93.7% vs 78.7%, p=0.005) were more common among dialysis patients. However, LV ejection fraction did not differ in dialysis vs non-dialysis SCA (LVEF 45.8 ± 19.0 vs 49.1 ± 16.2%; p=0.15). LV mass index was significantly higher (137.5 ± 40.5 vs 121.3 ± 43.3 g/m2; p=0.005), and LV hypertrophy (LVH) more common (55.6% vs 39.8%; p=0.018) among dialysis patients. The pattern of LVH was more likely to be concentric (defined by relative wall thickness [2xPWd / LVEDD] ≥0.45) in SCA patients on dialysis (62.9% vs 42.4%; p<0.001).
Conclusions: Dialysis patients with SCA are more likely to be younger as well as African American, but there were no significant differences in LV ejection fraction from non-dialysis SCA. In contrast, left ventricular hypertrophy, especially concentric LVH, was more common in dialysis patients that suffer SCA. These finding will inform ongoing investigations of high SCA burden in dialysis patients.
Author Disclosures: A.L. Aro: None. A. Uy-Evanado: None. S.G. Nair: None. K. Reinier: None. C. Teodorescu: None. D. Phan: None. G. Nichols: None. J. Jui: None. S.S. Chugh: Research Grant; Significant; NIH (NHLBI), R01HL126938 and R01HL122492.
- © 2016 by American Heart Association, Inc.