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Updated: May 24, 2025

Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
[Diastolic Dysfunction in CKD: Cause or Effect?s]
Eugenio Lembo1, Roberta Bottino2, Ida Matarazzo1
1U.O.C. Nefrologia e Dialisi, Università degli studi della Campania "Luigi Vanvitelli".
Insights
Left Ventricular Diastolic Dysfunction (LVDD) impairs heart relaxation, potentially leading to heart failure. Early diagnosis via echocardiography aids in assessing cardiovascular risk, especially in patients with chronic kidney disease (CKD).
Area of Science:
- Cardiology
- Nephrology
- Medical Diagnostics
Context:
- Left Ventricular Diastolic Dysfunction (LVDD) involves impaired heart relaxation and increased filling pressures.
- Isolated LVDD maintains normal ejection fraction (EF) but worsens with rising filling pressures.
- LVDD severity ranges from mild to advanced, potentially progressing to heart failure.
Purpose:
- To summarize the diagnostic criteria and clinical implications of LVDD.
- To highlight the updated echocardiographic categories for LVDD assessment.
- To underscore the association between LVDD, aging, hypertension, diabetes, and chronic kidney disease (CKD).
Summary:
- LVDD diagnosis utilizes echocardiography, with recent updates categorizing severity (normal, indeterminate, dysfunction).
- These categories help define cardiovascular (CV) risk in patients with or without CKD.
- LVDD prevalence rises in elderly, hypertensive, and diabetic individuals, often co-occurring with CKD.
Impact:
- Improved CV risk stratification in patients with LVDD, particularly those with CKD.
- Enhanced understanding of the link between LVDD and conditions like hypertension, diabetes, and CKD.
- Facilitates earlier detection and management of diastolic dysfunction to prevent heart failure progression.
Abstract:
Left Ventricular Diastolic Dysfunction (LVDD) describes changes in the heart's structure and function, leading to impaired ventricular relaxation and increased filling pressures during the diastolic phase of the cardiac cycle. In the context of isolated LVDD, the left ventricular end-diastolic volume, global contractility, and ejection fraction (EF) are normal, with EF being 50% or higher. However, as filling pressures progressively increase, diastolic dysfunction worsens. LVDD is classified into varying degrees of severity along a continuum that may ultimately lead to heart failure. The diagnosis of LVDD in its early stages is carried out using echocardiographic criteria, which also help to determine the severity of diastolic dysfunction. The most recent update of echocardiographic criteria includes three categories: normal, indeterminate and diastolic dysfunction, that allow us to define better the CV risk of patients with or without CKD. The prevalence of left ventricular diastolic dysfunction (LVDD) increases among the elderly, as well as in populations with hypertension and diabetes, which heightens their cardiovascular risk. Additionally, these conditions are frequently linked to chronic kidney disease (CKD). Although LVDD and CKD share a common pathogenic pattern, the relationship between the two conditions is not yet well understood.
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