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Relation Between Serum Ferritin Level and the Left Ventricular Mass Index (LVMI) in Maintenance Hemodialysis Patients

Received: 5 November 2018     Accepted: 16 November 2018     Published: 19 December 2018
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Abstract

Among hemodialysis (HD) patients, the left ventricular hypertrophy (LVH) is a common cardiovascular morbidity predictor. Ferritin level was considered as a clinical marker of iron storage and associated with cardiovascular mortality in chronic kidney disease (CKD) patients. The relationship between ferritin level and cardiac function in maintenance hemodialysis patients has not yet fully investigated. This study aimed to investigate the relationship between serum ferritin level and left ventricular mass index (LVMi) in hemodialysis patients. In this study, 70 regular chronic hemodialysis patients were included in a cross-sectional study (43 men and 27 women). The patients were sub-grouped into two groups according to the ferritin levels (patients with serum ferritin <800ng/ml (n=40), and patients with serum ferritin ≥800ng/ml (n=30)). Left ventricular mass (LVM), Left ventricular mass index (LVMi) and Left ventricular mass/hight 2.7 (LVM/Ht2.7) were evaluated by echocardiography. The patients with serum ferritin level ≥800 ng/ml showed significantly higher LVM, LVMI and LVM/Ht2.7 than other group. LVM, LVMI and LVM/Ht2.7 were significantly correlated to ferritin and hs-CRP. Regarding to the linear regression analysis, serum ferritin level was founded to be an independent predictors of LVM/Ht2.7 and but not for LVM nor LVMi. While, Highly sensitive C-reactive protein (hs-CRP) was founded to be independent predictors of LVM, LVMi and LVM/Ht2.7. This study showed that LVM, LVMI and LVM/ Ht2.7 are significantly elevated in patients with serum ferritin level ≥800 ng/ml. The serum ferritin was found to be independent predictors of LVH (represented by LVM/ Ht2.7) in maintenance HD patients.

Published in Cardiology and Cardiovascular Research (Volume 2, Issue 4)
DOI 10.11648/j.ccr.20180204.15
Page(s) 98-103
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Left Ventricular Mass Index, Ferritin, Hemodialysis, Echocardiography

References
[1] Subbiah AK, Chhabra YK, Mahajan S. Cardiovascular disease in patients with chronic kidney disease: a neglected subgroup. Heart Asia. 2016; 8: 56-61.
[2] Himmelfarb J. Relevance of oxidative pathways in the pathophysiology of chronic kidney disease. Cardiol Clin. 2005; 23: 319-30.
[3] Dikow R, Adamczak M, Henriquez DE, Ritz E. Strategies to decrease cardiovascular mortality in patients with end-stage renal disease. Kidney Int. 2002; 61: S5-S10.
[4] Adebiyi AA, Ogah OS, Aje A, Ojji DB, Adebayo AK, Oladapo OO, et al. Echocardiographic partition values and prevalence of left ventricular hypertrophy in hypertensive Nigerians. BMC Med Imag. 2006; 6: 10-1.
[5] Khan A, Khan WM, Ayub M, Humayun M, Haroon M. Ferritin is a marker of inflammation rather than iron deficiency in overweight and obese people. J Obesity. 2016; 2016: 7.
[6] Knovich MA, Storey JA, Coffman LG, Torti SV. Ferritin for the clinician. Blood rev. 2009; 23: 95-104.
[7] Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999; 340: 448-54.
[8] Hasuike Y, Nonoguchi H, Tokuyama M, Ohue M, Nagai T, Yahiro M, et al. Serum ferritin predicts prognosis in hemodialysis patients: the Nishinomiya study. Clin Exp Nephrol. 2010; 14: 349-55.
[9] Kalantar-Zadeh K, Rodriguez RA, Humphreys MH. Association between serum ferritin and measures of inflammation, nutrition and iron in haemodialysis patients. Nephrol Dial Transplant. 2004; 19: 141-9.
[10] Park KS, Ryu GW, Jhee JH, Kim HW, Park S, Lee SA, et al. Serum ferritin predicts mortality regardless of inflammatory and nutritional status in patients starting dialysis: A prospective cohort study. Blood Purif. 2015; 40: 209-17.
[11] Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986; 57: 450-8.
[12] Yildiz A, Memisoglu E, Oflaz H, Yazici H, Pusuroglu H, Akkaya V, et al. Atherosclerosis and vascular calcification are independent predictors of left ventricular hypertrophy in chronic haemodialysis patients. Nephrol Dial Transplant. 2005; 20: 760-7.
[13] Berl T, Henrich W. Kidney-heart interactions: epidemiology, pathogenesis, and treatment. Clin J Am Soc Nephrol. 2006; 1: 8-18.
[14] Zoccali C, Benedetto FA, Mallamaci F, Tripepi G, Giacone G, Stancanelli B, et al. Left ventricular mass monitoring in the follow-up of dialysis patients: prognostic value of left ventricular hypertrophy progression. Kidney Int. 2004; 65: 1492-8.
[15] de Simone G, Kizer JR, Chinali M, Roman MJ, Bella JN, Best LG, et al. Normalization for body size and population-attributable risk of left ventricular hypertrophy: the Strong Heart Study. Am J Hypertens. 2005; 18: 191-6.
[16] Chen SJ, Liu PC, Yang NI, Cheng CW, Wu IW, Wu MS, et al. Impact of definitions of left ventricular hypertrophy on left ventricular remodeling findings in patients with predialysis chronic kidney disease. Acta Cardiol Sin. 2012; 28: 42-52.
[17] Kim BS, Jeon DS, Shin MJ, Kim YO, Song HC, Lee SH, et al. Persistent elevation of C-reactive protein may predict cardiac hypertrophy and dysfunction in patients maintained on hemodialysis. Am J Nephrol. 2005; 25: 189-95.
[18] Park CW, Shin YS, Kim CM, Lee SY, Yu SE, Kim SY, et al. Increased C-reactive protein following hemodialysis predicts cardiac hypertrophy in chronic hemodialysis patients. Am J Kidney Dis. 2002; 40: 1230-9.
[19] Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation. 2000; 102: 2165-8.
[20] Stenvinkel P, Lindholm B. C-reactive protein in end-stage renal disease: are there reasons to measure it? Blood Purif. 2005; 23: 72-8.
[21] Kalantar-Zadeh K, Don BR, Rodriguez RA, Humphreys MH. Serum ferritin is a marker of morbidity and mortality in hemodialysis patients. Am J Kidney Dis. 2001; 37: 564-72.
[22] Panichi V, Rizza GM, Paoletti S, Bigazzi R, Aloisi M, Barsotti G, et al. Chronic inflammation and mortality in haemodialysis: effect of different renal replacement therapies. Results from the RISCAVID study. Nephrol Dial Transplant. 2008; 23: 2337-43.
[23] Hsu HS, Li CI, Liu CS, Lin CC, Huang KC, Li TC, et al. Iron deficiency is associated with increased risk for cardiovascular disease and all-cause mortality in the elderly living in long-term care facilities. Nut. 2013; 29: 737-43.
[24] Lapice E, Masulli M, Vaccaro O. Iron deficiency and cardiovascular disease: an updated review of the evidence. Curr Atheroscler Rep. 2013; 15: 358.
[25] Klip IT, Voors AA, Swinkels DW, Bakker SJ, Kootstra-Ros JE, Lam CS, et al. Serum ferritin and risk for new-onset heart failure and cardiovascular events in the community. Eur J Heart Fail. 2017; 19: 348-56.
[26] Yamanishi H, Iyama S, Yamaguchi Y, Kanakura Y, Iwatani Y. Relation between iron content of serum ferritin and clinical status factors extracted by factor analysis in patients with hyperferritinemia. Clin Biochem. 2002; 35: 523-9.
Cite This Article
  • APA Style

    Ahmed Eldeeb, Ahmed Hosny El-Adawy, Elshahat Yousef, Ahmed Ibrahim, Mostafa Anis Mahmoud, et al. (2018). Relation Between Serum Ferritin Level and the Left Ventricular Mass Index (LVMI) in Maintenance Hemodialysis Patients. Cardiology and Cardiovascular Research, 2(4), 98-103. https://doi.org/10.11648/j.ccr.20180204.15

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    ACS Style

    Ahmed Eldeeb; Ahmed Hosny El-Adawy; Elshahat Yousef; Ahmed Ibrahim; Mostafa Anis Mahmoud, et al. Relation Between Serum Ferritin Level and the Left Ventricular Mass Index (LVMI) in Maintenance Hemodialysis Patients. Cardiol. Cardiovasc. Res. 2018, 2(4), 98-103. doi: 10.11648/j.ccr.20180204.15

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    AMA Style

    Ahmed Eldeeb, Ahmed Hosny El-Adawy, Elshahat Yousef, Ahmed Ibrahim, Mostafa Anis Mahmoud, et al. Relation Between Serum Ferritin Level and the Left Ventricular Mass Index (LVMI) in Maintenance Hemodialysis Patients. Cardiol Cardiovasc Res. 2018;2(4):98-103. doi: 10.11648/j.ccr.20180204.15

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  • @article{10.11648/j.ccr.20180204.15,
      author = {Ahmed Eldeeb and Ahmed Hosny El-Adawy and Elshahat Yousef and Ahmed Ibrahim and Mostafa Anis Mahmoud and Hany Abdel Shakour and Mohamed Omran},
      title = {Relation Between Serum Ferritin Level and the Left Ventricular Mass Index (LVMI) in Maintenance Hemodialysis Patients},
      journal = {Cardiology and Cardiovascular Research},
      volume = {2},
      number = {4},
      pages = {98-103},
      doi = {10.11648/j.ccr.20180204.15},
      url = {https://doi.org/10.11648/j.ccr.20180204.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20180204.15},
      abstract = {Among hemodialysis (HD) patients, the left ventricular hypertrophy (LVH) is a common cardiovascular morbidity predictor. Ferritin level was considered as a clinical marker of iron storage and associated with cardiovascular mortality in chronic kidney disease (CKD) patients. The relationship between ferritin level and cardiac function in maintenance hemodialysis patients has not yet fully investigated. This study aimed to investigate the relationship between serum ferritin level and left ventricular mass index (LVMi) in hemodialysis patients. In this study, 70 regular chronic hemodialysis patients were included in a cross-sectional study (43 men and 27 women). The patients were sub-grouped into two groups according to the ferritin levels (patients with serum ferritin 2.7 (LVM/Ht2.7) were evaluated by echocardiography. The patients with serum ferritin level ≥800 ng/ml showed significantly higher LVM, LVMI and LVM/Ht2.7 than other group. LVM, LVMI and LVM/Ht2.7 were significantly correlated to ferritin and hs-CRP. Regarding to the linear regression analysis, serum ferritin level was founded to be an independent predictors of LVM/Ht2.7 and but not for LVM nor LVMi. While, Highly sensitive C-reactive protein (hs-CRP) was founded to be independent predictors of LVM, LVMi and LVM/Ht2.7. This study showed that LVM, LVMI and LVM/ Ht2.7 are significantly elevated in patients with serum ferritin level ≥800 ng/ml. The serum ferritin was found to be independent predictors of LVH (represented by LVM/ Ht2.7) in maintenance HD patients.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Relation Between Serum Ferritin Level and the Left Ventricular Mass Index (LVMI) in Maintenance Hemodialysis Patients
    AU  - Ahmed Eldeeb
    AU  - Ahmed Hosny El-Adawy
    AU  - Elshahat Yousef
    AU  - Ahmed Ibrahim
    AU  - Mostafa Anis Mahmoud
    AU  - Hany Abdel Shakour
    AU  - Mohamed Omran
    Y1  - 2018/12/19
    PY  - 2018
    N1  - https://doi.org/10.11648/j.ccr.20180204.15
    DO  - 10.11648/j.ccr.20180204.15
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 98
    EP  - 103
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20180204.15
    AB  - Among hemodialysis (HD) patients, the left ventricular hypertrophy (LVH) is a common cardiovascular morbidity predictor. Ferritin level was considered as a clinical marker of iron storage and associated with cardiovascular mortality in chronic kidney disease (CKD) patients. The relationship between ferritin level and cardiac function in maintenance hemodialysis patients has not yet fully investigated. This study aimed to investigate the relationship between serum ferritin level and left ventricular mass index (LVMi) in hemodialysis patients. In this study, 70 regular chronic hemodialysis patients were included in a cross-sectional study (43 men and 27 women). The patients were sub-grouped into two groups according to the ferritin levels (patients with serum ferritin 2.7 (LVM/Ht2.7) were evaluated by echocardiography. The patients with serum ferritin level ≥800 ng/ml showed significantly higher LVM, LVMI and LVM/Ht2.7 than other group. LVM, LVMI and LVM/Ht2.7 were significantly correlated to ferritin and hs-CRP. Regarding to the linear regression analysis, serum ferritin level was founded to be an independent predictors of LVM/Ht2.7 and but not for LVM nor LVMi. While, Highly sensitive C-reactive protein (hs-CRP) was founded to be independent predictors of LVM, LVMi and LVM/Ht2.7. This study showed that LVM, LVMI and LVM/ Ht2.7 are significantly elevated in patients with serum ferritin level ≥800 ng/ml. The serum ferritin was found to be independent predictors of LVH (represented by LVM/ Ht2.7) in maintenance HD patients.
    VL  - 2
    IS  - 4
    ER  - 

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Author Information
  • Nephrology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Department of Cardiovascular Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Nephrology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Nephrology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Nephrology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Department of Cardiovascular Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Chemistry Department, Faculty of Science, Helwan University, Cairo, Egypt

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