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In LV hypertrophy, the muscle fibers in the heart’s main pumping chamber enlarge and, over time, thicken. We see it in patients with longstanding hypertension or a valve disease such as aortic stenosis or regurgitation. We also see these changes in elite athletes, for example, weightlifters and long-distance runners.
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Several factors conjure to increase sympathetic activity in ESRD patients, including low vagal tone, afferent signals originating in the end-stage kidneys, and sleep apnea, a condition that is ≥10 times more frequent in ESRD patients than in the background general population. 7 Sympathetic overactivity poses a high arrhythmogenic risk in ESRD.
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