Related Experiment Video

Updated: May 25, 2026

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

Elevated E/E' predicts cardiovascular events in hemodialysis patients with preserved systolic function

Yuko Iwabuchi1, Tetsuya Ogawa, Tomoko Inoue

  • 1Department of Medicine, Kidney Center, Tokyo Women's Medical University, Japan.

Internal Medicine (Tokyo, Japan)
|January 17, 2012
PubMed

Insights

In hemodialysis (HD) patients with preserved systolic function, the ratio of early transmitral flow velocity to early mitral annular velocity (E/E') is a strong predictor of cardiovascular events.

Area of Science:

  • Cardiology
  • Nephrology
  • Echocardiography

Background:

  • Cardiovascular disease is a major cause of mortality in patients undergoing hemodialysis (HD).
  • Preserved left ventricular (LV) systolic function is common in HD patients, necessitating evaluation of diastolic function for risk stratification.

Purpose of the Study:

  • To determine if diastolic function, specifically the E/E' ratio, can predict cardiovascular (CV) events in HD patients with preserved systolic function.
  • To assess the predictive value of the E/E' ratio compared to other echocardiographic parameters.

Main Methods:

  • A cohort study involving 161 HD patients with preserved systolic function.
  • Measurement of the E/E' ratio using tissue Doppler imaging.
  • Stratification of patients based on CV event occurrence over a 4-year follow-up.

Main Results:

  • A significantly higher E/E' ratio was observed in patients who experienced CV events (15.18 ± 5.78) compared to those who did not (12.32 ± 4.23).
  • Kaplan-Meier analysis showed a significantly higher incidence of CV events in patients with E/E' > 15.
  • Multivariate Cox regression identified the E/E' ratio as a significant predictor of CV events.

Conclusions:

  • Elevated E/E' ratio is a valuable predictor of cardiovascular events in chronic HD patients.
  • The E/E' ratio demonstrates superior predictive capability for CV events compared to other echocardiographic measures in this population.
Abstract

Related Concept Videos

Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis

Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...