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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Left ventricular diastolic dysfunction in the early stage of chronic kidney disease

Takenori Otsuka1, Makoto Suzuki, Hisao Yoshikawa

  • 1Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan. nori3649@hotmail.com

Journal of Cardiology
|September 29, 2009
PubMed

Insights

Kidney dysfunction, even in early stages, can cause left ventricular (LV) diastolic dysfunction. Advanced Doppler imaging techniques can detect these subtle changes in heart function related to chronic kidney disease (CKD).

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • The impact of kidney dysfunction on left ventricular (LV) diastolic function remains largely uncharacterized.
  • Chronic kidney disease (CKD) affects a significant portion of the population, highlighting the need to understand its cardiovascular implications.

Purpose of the Study:

  • To investigate the relationship between the severity of kidney dysfunction and left ventricular (LV) diastolic function.
  • To determine if early stages of chronic kidney disease (CKD) are associated with diastolic dysfunction.
  • To evaluate the utility of Doppler indices in detecting subtle changes in diastolic function.

Main Methods:

  • Echocardiography and tissue Doppler imaging were performed on 40 non-CKD and 202 CKD patients (aged 40-89).
  • Patients were stratified into five groups based on estimated glomerular filtration rate (GFR) to assess kidney dysfunction severity.
  • Analysis focused on LV systolic and diastolic function parameters, including mitral inflow velocities (E, A), E/A ratio, deceleration time, and early diastolic mitral annular velocity (Ea).

Main Results:

  • No significant differences in LV systolic function were observed across groups.
  • Mitral E velocity decreased, while mitral A velocity and the E/A ratio increased with worsening kidney dysfunction.
  • Tissue Doppler imaging revealed that early diastolic mitral annular velocity (Ea) was higher in normal subjects compared to CKD patients, with E/Ea ratio increasing significantly with kidney dysfunction severity.
  • Doppler indices (A, E/A, Ea) could differentiate between normal subjects and those with early-stage CKD.

Conclusions:

  • Left ventricular diastolic dysfunction is present even in the early stages of chronic kidney disease (CKD).
  • Conventional and tissue Doppler echocardiography are effective tools for detecting subtle diastolic function changes associated with kidney dysfunction.
  • These findings underscore the importance of monitoring cardiac function in patients with CKD.
Abstract

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