Association Of Central Arterial Blood Pressure And Left Ventricular Hypertrophy In Patients With Chronic Kidney Disease

Background:Central arterial blood pressure（CABP）is more closely related to cardiovascular pathophysiology than brachial arterial blood pressure（BABP）,and can more truly reflect the conditions of the left ventricle and coronary artery.The purpose of this study is to investigate the relationship between CABP and left ventricular hypertrophy（LVH）in patients with chronic kidney disease（CKD）.Methods:We collected and analyzed the medical records of patients with CKD hospitalized in the Nephrology Department of Zhejiang Provincial People’s Hospital,China from January 2017 to May 2019.Demographic,laboratory,echocardiographic,brachial and central arterial blood pressure parameters were retrieved from medical records.CABP was measured using the Sphygmo Cor^?CvMS（AtCor,Australia） device and its corresponding software.Multivariate logistic regression analyses were performed to identify independent predictors of LVH.Results:This study included and analyzed 289 patients with CKD,divided into LVH group and normal group.We found that compared with the LVH group,central systolic blood pressure,central pulse pressure,BUN,Cr,P,TG were lower,Alb,e GFR,and Hb were higher,and the difference was statistically significant（P>0.05）.Grouping the central systolic blood pressure（CSBP）and central pulse pressure（CPP）into quartiles,we found that BUN and LVMI in the highest quartile of CSBP and CPP were higher than in the lowest quartile group,e GRF and Hb was lower than the lowest quartile group,and the highest quartile group had a higher proportion of patients who progressed to CKD stage 5 and underwent hemodialysis treatment,and the difference was statistically significant（P<0.05）.After grouping according to CKD stage,the CSBP,CPP,and left ventricular mass index of CKD stage 5 patients were higher than those of CKD stage 1,and the difference was statistically significant（P<0.05）.In the correlation analysis we found that left ventricular mass index（LVMI）was positively associated with both central and brachial blood pressures,and with the increase of systolic blood pressure and pulse pressure,the incidence of LVH increases.After adjusting for confounding factors,multivariate logistic regression analysis showed that CPP,hemoglobin,and phosphorus are risk factors for LVH.Among them,CPP is the most significant independent risk factor for LVH（OR=5.597,95%CI:2.363-13.259,P<0.001）.Conclusion:We found that in the group of CKD,patients with high CSBP and high CPP have poor renal function and left ventricular function.The incidence of LVH increased with the increase of CPP.CPP,hemoglobin and phosphorus are risk factors of LVH,and CPP is the most significant independent risk factor.