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The association between left ventricular diastolic function and a mild-to-moderate decrease in glomerular filtration

M Pecková1, J Charvat, O Schuck

  • 1Department of Medicine, University Hospital Motol, Second Medical School, Charles University, V Úvalu 84, 150 06 Prague 5, Czech Republic. marenkapecka@gmail.com

The Journal of International Medical Research
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Summary

In type 2 diabetes patients, impaired left ventricular (LV) relaxation (E') is linked to reduced kidney function (eGFR). This explains the association between renal impairment and LV diastolic pressure (E/E').

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Area of Science:

  • Cardiology
  • Nephrology
  • Diabetology

Background:

  • Type 2 diabetes mellitus is associated with cardiovascular and renal complications.
  • Left ventricular (LV) diastolic dysfunction is common in diabetic patients.
  • The relationship between renal function and LV diastolic parameters needs further elucidation.

Purpose of the Study:

  • To investigate the association between echocardiographic markers of LV diastolic function and renal function in patients with type 2 diabetes.
  • To explore the role of LV relaxation (E") in the link between estimated glomerular filtration rate (eGFR) and LV filling pressures (E/E").

Main Methods:

  • Prospective study of 82 type 2 diabetes patients with mild-to-moderate renal impairment.
  • Echocardiography to assess LV diastolic function parameters, including E and E'.
  • Calculation of estimated glomerular filtration rate (eGFR) and the E/E' ratio.
  • Cluster analysis to identify patient subgroups based on E' values.

Main Results:

  • A significant correlation was observed between eGFR and the E/E' ratio.
  • Cluster analysis identified two subgroups with different E' values but similar eGFRs.
  • The correlation between eGFR and E/E' was significant only in patients with lower E' values (≤ 7.1 cm/s).

Conclusions:

  • Deterioration in LV relaxation (E") is the underlying mechanism connecting mild-to-moderate renal impairment and elevated LV end-diastolic pressure (E/E') in type 2 diabetes.
  • These findings highlight the importance of assessing LV diastolic function in diabetic patients with impaired renal function, even without prior cardiovascular events.