TITLE:
Interdialytic 24-Hours Ambulatory Blood Pressure versus Dialysis Unit Blood Pressure for the Diagnosis of Electrocardiographic-Left Ventricular Hypertrophy in Chronic Hemodialysis Black Patients
AUTHORS:
Cédric Kabemba Ilunga, François Bompeka Beka Lepira, Jean Robert Rissassi Makulo, Yves Lubenga, Trésor Mvunzi, Noel Utshudi, Aliocha Nkodila, Vieux Momeme Mokoli, Ernest Kiswaya Sumaili, Nazaire Mangani Nseka, Eleuthère Vita Kintoki
KEYWORDS:
24-Hours ABPM, Dialysis Unit BPs, ECG-LVH, Diagnostic Performance, Chronic Hemodialysis, Black Africans
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.9 No.11,
November
27,
2019
ABSTRACT: Background and Aim: In hemodialysis patients, 24-hours interdialytic ABPM better detects TOD than dialysis unit blood pressure. Therefore, the
present study was aimed to assess the diagnostic performance of 24-hours ABPM
vs. dialysis unit BPs for the diagnosis of ECG-LVH in steady state chronic hemodialysis black patients. Methods: From March 31 to September 30, 2018, interdialytic ABPM was performed after a
mid-week hemodialysis session for 24 hours using a Spacelab 90207 ABPM monitor
in the non-access arm in 45 stable chronic hemodialysis black patients (age ≥ 20 years, hemodialysis for
at least 3 months and informed consent) attending 3 hemodialysis centers in
Kinshasa. Ambulatory BP was recorded every 20 minutes during the day (6 AM to
10 PM) and every 30 minutes during the night (10 PM to 6 AM). ECG-LVH was defined using Cornell
product criteria. ROC curve method was used to assess the performance of
dialysis unit BPs vs. interdialytic 24-hours ABPM in diagnosing ECG-LVH. P 0.05
defined the level of statistical significance. Results: Whatever the
method of BP measurement, all the SBP values were related to ECG-LVH with
similar AUC and overlapping 95% CI;
however, they were not significantly different from each other. 24-hours
interdialytic ambulatory SBP (AUC 0.748; 95% CI 0.58 - 0.94)
had the highest area under the curve. Conclusion: The present study
showed that although all the two BP measurement methods equally detected
ECG-LVH, 24-hours ABPM tended to have the highest diagnostic performance.