Left Ventricular Hypertrophy Patterns in Diabetic Versus Non-Diabetic Hypertensive Patients on Maintenance Hemodialysis in Peshawar
DOI:
https://doi.org/10.61919/bm92fm18Keywords:
Cardiomyopathies; Cardiovascular Diseases; Cross-Sectional Studies; Diabetes Mellitus; Heart Failure; Hypertension; Hypertrophy, Left Ventricular; Kidney Failure, Chronic; Pakistan; Renal Dialysis; Ventricular Remodeling.Abstract
Background: Cardiovascular disease continues to constitute a major source of morbidity and mortality among patients with end-stage renal disease undergoing maintenance hemodialysis, with left ventricular hypertrophy being one of its structural predictors. Hypertension has been established as the important predictor of left ventricular remodeling in these patients, although diabetic patients could have an adverse myocardial phenotype. Objective: To compare the echocardiographic variables and left ventricular geometric patterns of diabetic and non-diabetic hypertensive patients undergoing maintenance hemodialysis in Peshawar, Pakistan. Methodology: This cross-sectional comparative study was conducted on 94 patients with hypertension who were on maintenance hemodialysis for at least three months, with each of the two groups having equal number of patients. Patients in each group were subjected to transthoracic echocardiography 12 to 24 hours after a mid-week dialysis session. Independent-samples t-test and Chi-square analyses were employed to compare left ventricular mass index, relative wall thickness, interventricular septum thickness, posterior wall thickness and left ventricular geometric patterns of patients belonging to the two groups. Results: Diabetic hypertensive patients had a higher left ventricular mass index than non-diabetic hypertensive patients (148.6 ± 22.4 vs 126.3 ± 18.5 g/m²; p<0.001) as well as relative wall thickness (0.48 ± 0.06 vs 0.42 ± 0.05; p<0.001). Concentric hypertrophy was observed in greater numbers of diabetic hypertensive patients than non-diabetic hypertensive patients (57.4% vs 17.0%), and eccentric hypertrophy was more prevalent in non-diabetic patients (44.7% vs 27.7%). There were significant differences in left ventricular geometry by diabetic status (χ²=13.064; p=0.004). Conclusion: Diabetic status was associated with higher left ventricular mass index, greater relative wall thickness and concentric hypertrophy in hypertensive patients under maintenance hemodialysis. Longitudinal studies should be done in future to determine the causal relationships involved
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Copyright (c) 2026 Shah Abdul Latif, Ahmed Mustafa Nadeem, Isbah Aman, Nauman Akhtar, Mashall Jan, Zara Mushtaq, Musab Bin Zubair (Author)
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