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Updated: Sep 27, 2025

Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Association of Left Ventricular Diastolic Dysfunction With Cardiovascular Outcomes in Patients With Pre-dialysis

Sang Heon Suh1, Tae Ryom Oh1, Hong Sang Choi1

  • 1Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea.

Frontiers in Cardiovascular Medicine
|April 11, 2022
PubMed

Insights

Left ventricular diastolic dysfunction (LVDD) significantly increases cardiovascular event risk and mortality in pre-dialysis chronic kidney disease (CKD) patients. This association is independent of systolic function and unaffected by other clinical factors.

Area of Science:

  • Cardiology
  • Nephrology
  • Cardiorenal Medicine

Background:

  • Left ventricular diastolic dysfunction (LVDD) is understudied in pre-dialysis chronic kidney disease (CKD).
  • Understanding LVDD's impact on cardiovascular (CV) outcomes in CKD is crucial.

Purpose of the Study:

  • To investigate the association between LVDD and CV outcomes in pre-dialysis CKD patients.
  • To determine if LVDD independently predicts adverse CV events and mortality.

Main Methods:

  • Utilized data from 2,135 pre-dialysis CKD patients in the KNOW-CKD cohort.
  • Defined LVDD using the E/e' ratio (>14) and employed Cox regression analysis.

Main Results:

  • LVDD significantly elevated the risk of composite CV events (aHR 2.194) and all-cause mortality (aHR 1.830).
  • Findings remained significant in sensitivity analyses excluding systolic dysfunction and across various subgroups.

Conclusions:

  • LVDD is an independent predictor of adverse CV outcomes and mortality in pre-dialysis CKD.
  • LVDD's detrimental effect on CKD patients is not influenced by LV systolic function or other clinical variables.
Abstract

Keywords:
all-cause mortalitycardiovascular outcomechronic kidney diseaseheart failureleft ventricular diastolic dysfunction

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