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Diastolic dysfunction is an independent predictor of cardiovascular events in incident dialysis patients with preserved systolic function

Title
Diastolic dysfunction is an independent predictor of cardiovascular events in incident dialysis patients with preserved systolic function
Authors
Han J.H.Han J.S.Kim E.J.Doh F.M.Koo H.Kim C.H.Lee M.J.Oh H.J.Park J.T.Han S.H.Ryu D.-R.Yoo T.-H.Kang S.-W.
Ewha Authors
류동열
SCOPUS Author ID
류동열scopus
Issue Date
2015
Journal Title
PLoS ONE
ISSN
1932-6203JCR Link
Citation
vol. 10, no. 3
Publisher
Public Library of Science
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Background: Diastolic heart failure (HF), the prevalence of which is gradually increasing, is associated with cardiovascular (CV) morbidity and mortality in the general population and, more specifically, in patients with end-stage renal disease (ESRD). However, the impact of diastolic dysfunction on CV outcomes has not been studied in incident dialysis patients with preserved systolic function. Methods: This prospective observational cohort study investigates the clinical consequence of diastolic dysfunction and the predictive power of diastolic echocardiographic parameters for CV events in 194 incident ESRD patients with normal or near normal systolic function, who started dialysis between July 2008 and August 2012. Results: During a mean follow-up duration of 27.2 months, 57 patients (29.4%) experienced CV events. Compared to the CV event-free group, patients with CV events had a significantly higher left ventricular (LV) mass index, ratio of early mitral flow velocity (E) to early mitral annulus velocity (E') (E/E'), LA volume index (LAVI), deceleration time, and right ventricular systolic pressure, and a significantly lower LV ejection fraction and E'. In multivariate Cox proportional hazard analysis, E/E'> 15 and LAVI>32 mL/m2 significantly predicted CV events (E/E'>15: hazard ratio [HR] = 5.40, 95% confidence interval [CI] = 2.73-10.70, P< .001; LAVI>32 mL/m2: HR = 5.56, 95% CI = 2.28-13.59, P< .001]. Kaplan-Meier analysis revealed that patients with both E/E'> 15 and LAVI>32mL/m2 had the worst CV outcomes. Conclusion: An increase in E/E' or LAVI is a significant risk factor for CV events in incident dialysis patients with preserved LV systolic function. © 2015 Han et al.
DOI
10.1371/journal.pone.0118694
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의학전문대학원 > 의학과 > Journal papers
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