Left Ventricular Diastolic Dysfunction across Levels of Kidney Function: A Cross-Sectional Study Based on Routine...

Area of Science:

• Cardiology
• Nephrology
• Diagnostic Imaging

Background:

• Left ventricular diastolic dysfunction (LVDD) frequently coexists with chronic kidney disease.
• Echocardiography is crucial for assessing cardiac function, including diastolic function.

Purpose of the Study:

• To investigate the association between varying stages of kidney function and echocardiographic parameters indicative of LVDD.
• To determine the prevalence of LVDD abnormalities across different levels of estimated glomerular filtration rate (eGFR).

Main Methods:

• Retrospective analysis of 4022 patients with available serum creatinine and echocardiography data.
• Patients were stratified into four groups based on eGFR: normal (≥90), mild (60-90), moderate (30-60), and severe (<30 mL/min/1.73 m²).
• Logistic and linear regression analyses were used to assess the relationship between kidney function and LVDD parameters.

Main Results:

• Abnormal LVDD echocardiography parameters, including E/e' ratio, left atrial volume index (LAVI), TR velocity, and left ventricular mass index (LVMI), were observed across all stages of kidney function.
• Patients with mildly decreased kidney function showed increased odds of abnormal E/e' ratio (OR: 1.51).
• Patients with moderate and severe kidney dysfunction exhibited significantly higher odds for multiple LVDD abnormalities, with a clear inverse association between eGFR and LVDD parameters.

Conclusions:

• Echocardiographic evidence of LVDD is detectable even in the early stages of kidney dysfunction.
• A progressive decline in kidney function is associated with a stepwise increase in the risk and severity of LVDD.
• These findings highlight the interconnectedness of cardiac and kidney health and the importance of cardiac screening in patients with kidney disease.