Relation of proximal aorta stiffness to left ventricular diastolic function in patients with end-stage renal disease

We examined the relationship between proximal aortic stiffness and left ventricular (LV) diastolic function in patients with end-stage renal disease (ESRD).

We studied 99 patients with ESRD with preserved LV ejection fraction greater than 50% and 83 controls. We assessed the aorta stiffness by measuring the pulse wave velocity (PWV) in the proximal aorta (PWVr) using a novel echo application and in the descending aorta (PWVcf) using a foot-to-foot method. Patients were classified according to LV diastolic filling pattern into normal, delayed relaxation, pseudonormal, and restrictive filing pattern groups.

Patients with ESRD had increased PWVr, PWVcf, and LV mass index (LVMI) compared with controls (all P < .0001). Patients with advanced diastolic dysfunction showed increased PWVr (P < .001) and PWVcf (P = .007) compared with those with mild diastolic dysfunction. PWVr was correlated to PWVcf (r = 0.74, P < .001) in patients with ESRD. Multivariate linear regression analysis revealed that PWVr was independently correlated to both LVMI and LV diastolic filling pattern.

Increased LVMI, advanced LV diastolic dysfunction, and generalized aortic stiffening were observed in patients with ESRD. Proximal aorta stiffness is associated with both increased LVMI and advanced LV diastolic dysfunction in those patients.