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We sought to examine the relationships of serum apolipoprotein B (apo B) levels with left ventricular (LV) structural and functional features, especially with LV remodeling indices in peritoneal dialysis (PD) patients.
A total of 182 patients with end-stage renal disease (ESRD) receiving PD were included in present study. Conventional echocardiography examination and tissue Doppler imaging (TDI) were performed. Clinical information and laboratory data were also collected. Analyses of echocardiographic features and LV remodeling indices were performed according to apo B quartiles groups. And multivariate linear regression models were used to determine the associations between serum apo B and left ventricular end-diastolic volume (LVEDV).
Serum apoB had inverse correlations with most of the LV structural and functional indices studied. High serum apoB level was significantly related to the decrease in left atrium dimensions (r = -0.20, P = 0.011), LV dimensions (end-diastolic diameter: r = -0.27, P = 0.001; end-systolic diameter: r = -0.24, P = 0.003), E/A ratio (r =-0.38, P < 0.001) and LV volumetric dimensions (end-diastolic volume: r = -0.27, P < 0.001; end-systolic volume: r = -0.28, P < 0.001). After adjustment for clinical confounding factors, the effect of serum apoB on LV remodeling (characterized by left ventricular end-diastolic volume dilatation) modestly weakened but remained statistically significant (adjusted r = -0.16, P = 0.038), while other associations disappeared. In multivariate linear regression analysis, conditional lipid profiles were not significantly associated with LV eccentric remodeling, whereas serum apoB was an independent determinant of LV dilatation.
In our PD population, serum apoB was significantly and inversely associated with LV dilatation, independently of conventional lipids and other CV risk factors. It suggests that low serum apoB concentrations may be a sensitive and powerful risk markers of eccentric left ventricular geometry remodeling, which might help to risk-stratify maintenance peritoneal dialysis patients.