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Aim: Multiple measurements of depression symptoms over time were more predictive of cardiovascular mortality than a single time measurement performed at baseline. The aim of this study is to evaluate the association of the course of depression symptoms, based on repeated assessments of depression symptoms over time, with left ventricular mass index (LVMI) and left ventricular filling pressure (LVFP) in patients on haemodialysis (HD)., Methods: The level of depression symptoms in 61 patients on HD were prospectively assessed using the Beck Depression Inventory (BDI) at baseline and at three intervals (5, 10, 15 months). Doppler echocardiographic examinations were performed at the end of follow up., Results: At the end of follow up, the patients were divided into three groups according to their course of depression symptoms: non-depression (n = 21), intermittent depression (n = 23) and persistent depression (n = 17). LVMI and LVFP were significantly increased in the persistent depression symptoms group compared to those of the non-depression symptoms group and the intermittent depression symptoms group. Persistent depression symptoms were independently associated with LVMI (β-coefficient = 0.347, P = 0.017) and LVFP (β-coefficient = 0.274, P = 0.048) after adjustment for age, sex, systolic blood pressure, diastolic blood pressure, diabetes and interdialytic weight gain., Conclusion: In our study, persistent depression symptoms were associated with left ventricular hypertrophy and diastolic dysfunction. Our data may provide a more complete understanding of cardiovascular risk associated with depression symptoms in patients on HD., (© 2010 The Authors. Nephrology © 2010 Asian Pacific Society of Nephrology.)

Background: Left ventricular filling pressure (LVFP) is related to the long-term prognosis in end-stage renal disease. The aims of this study were to evaluate the time course of the changes in LVFP, the predictors for the changes of LVFP, and the plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels as indicators for the changes of LVFP in chronic hemodialysis (HD)., Methods: This study was designed prospectively. Doppler echocardiographic examinations and measurement of plasma NT-proBNP levels were performed in 37 consecutive patients on chronic HD and repeated at median of 43 months later. A ratio of peak early transmitral flow velocity to peak early diastolic mitral annular velocity (E/Em), an estimate of LVFP, was calculated., Results: E/Em ratios were significantly increased during the follow-up period. In multivariate analysis, age and changes of LVMI were independently associated with the changes of E/Em ratios. The plasma NT-proBNP levels were independently associated with E/Em at baseline and at the end of follow-up. The changes of plasma NT-proBNP levels were independently associated with changes of E/Em ratios (b-coefficient 0.453, p = 0.003)., Conclusions: Our data suggest that the deterioration of LVFP parallels with the progression of LV hypertrophy. Monitoring the plasma NT-proBNP levels might be useful for the detection of the LVFP changes in chronic HD.