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Echocardiographic changes in patients with stage 3-5 chronic kidney disease and left ventricular diastolic

Leszek Gromadziński1, Piotr Pruszczyk2

  • 1Department of Internal Diseases, Gastroenterology and Hepatology, University Clinical Hospital in Olsztyn, Olsztyn, Poland ; Department of Internal Diseases, Gastroenterology, Cardiology and Infectiology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.

Cardiorenal Medicine
|March 5, 2015
PubMed

Insights

Reduced mitral annular plane systolic excursion (MAPSE) is an independent predictor of left ventricular (LV) diastolic dysfunction in chronic kidney disease (CKD) patients. This finding aids in diagnosing heart failure in CKD individuals.

Area of Science:

  • Cardiology
  • Nephrology
  • Echocardiography

Background:

  • Left ventricular (LV) diastolic dysfunction is a common complication in chronic kidney disease (CKD) patients, often leading to congestive heart failure.
  • Early detection and management of LV diastolic dysfunction are crucial for improving outcomes in CKD patients.

Purpose of the Study:

  • To evaluate echocardiographic parameters in CKD patients with and without LV diastolic dysfunction.
  • To identify independent predictors of LV diastolic dysfunction in CKD.

Main Methods:

  • Seventy ambulatory CKD patients (stages 3-5) and 26 controls underwent standard echocardiography and tissue Doppler imaging.
  • Patients were categorized into diastolic dysfunction (DD) and without diastolic dysfunction (WDD) groups based on lateral mitral early diastolic velocity (EmLVlat).

Main Results:

  • Patients in the DD group exhibited significantly lower mitral annular plane systolic excursion (MAPSE) and lateral mitral annular systolic velocity (SmLVlat) compared to the WDD group.
  • MAPSE demonstrated high diagnostic accuracy (Area Under Curve = 0.801) for LV diastolic dysfunction, with a threshold of ≤13 mm showing 84.4% sensitivity and 75.8% specificity.
  • Reduced MAPSE was identified as the sole independent predictor of LV diastolic dysfunction in CKD patients (OR = 0.39).

Conclusions:

  • Reduced MAPSE is a significant independent predictive factor for LV diastolic dysfunction in CKD patients.
  • SmLVlat was not found to be an independent predictor in this cohort.
  • MAPSE serves as a valuable echocardiographic marker for assessing diastolic function in CKD.
Abstract

Keywords:
Chronic kidney diseaseDiastolic dysfunctionTissue Doppler echocardiography

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