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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism
11:04

Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism

Published on: September 1, 2014

Relation of plasma indoxyl sulfate levels and estimated glomerular filtration rate to left ventricular diastolic

Bummei Sato1, Daiji Yoshikawa, Hideki Ishii

  • 1Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

The American Journal of Cardiology
|December 12, 2012
PubMed

Insights

High levels of indoxyl sulfate (IS), a uremic toxin, and reduced kidney function are linked to left ventricular (LV) diastolic dysfunction in patients with preserved systolic function.

Area of Science:

  • Nephrology
  • Cardiology
  • Toxicology

Background:

  • Diastolic heart failure (HF) carries a prognosis as poor as systolic HF.
  • Patients with left ventricular (LV) diastolic HF exhibit higher chronic kidney disease-associated mortality than those with systolic HF.
  • Indoxyl sulfate (IS), a known uremic toxin, has demonstrated adverse effects on cardiac cells in vitro.

Purpose of the Study:

  • To investigate the clinical association between IS, chronic kidney disease, and LV diastolic dysfunction.
  • To determine if elevated IS levels and impaired kidney function are risk factors for diastolic dysfunction.

Main Methods:

  • The study included 204 consecutive patients with preserved LV systolic function.
  • Echocardiography was used to assess LV diastolic function.
  • Plasma IS levels and estimated glomerular filtration rate (eGFR) were measured from blood samples.

Main Results:

  • 75 out of 204 patients (37%) presented with LV diastolic dysfunction.
  • A significantly lower prevalence of LV diastolic dysfunction was observed in patients with lower plasma IS levels (≤1.0 μg/ml) compared to those with higher levels (29% vs. 51%, p <0.001).
  • Elevated IS levels and/or reduced eGFR were significantly associated with a higher prevalence of LV diastolic dysfunction across different eGFR categories.

Conclusions:

  • Elevated plasma IS levels and/or reduced estimated glomerular filtration rate (eGFR) are associated with an increased risk of developing left ventricular (LV) diastolic dysfunction.
  • These findings highlight the clinical relevance of uremic toxins and kidney function in the context of diastolic heart failure.
  • Further research may explore therapeutic strategies targeting IS and kidney function to improve outcomes in patients with diastolic dysfunction.

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