Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and Determinants

Background. Diastolic dysfunction is common among dialysis patients and is associated with increased morbidity and mortality. Novel echocardiographic speckle tracking strain analysis permits accurate assessment of left ventricular diastolic function, independent of loading conditions and taking all...

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Main Authors: Mihály K. de Bie, Nina Ajmone Marsan, André Gaasbeek, Jeroen J. Bax, Marc Groeneveld, Bas A. Gabreels, Victoria Delgado, Ton J. Rabelink, Martin J. Schalij, J. Wouter Jukema
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:International Journal of Nephrology
Online Access:http://dx.doi.org/10.1155/2012/963504
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author Mihály K. de Bie
Nina Ajmone Marsan
André Gaasbeek
Jeroen J. Bax
Marc Groeneveld
Bas A. Gabreels
Victoria Delgado
Ton J. Rabelink
Martin J. Schalij
J. Wouter Jukema
author_facet Mihály K. de Bie
Nina Ajmone Marsan
André Gaasbeek
Jeroen J. Bax
Marc Groeneveld
Bas A. Gabreels
Victoria Delgado
Ton J. Rabelink
Martin J. Schalij
J. Wouter Jukema
author_sort Mihály K. de Bie
collection DOAJ
description Background. Diastolic dysfunction is common among dialysis patients and is associated with increased morbidity and mortality. Novel echocardiographic speckle tracking strain analysis permits accurate assessment of left ventricular diastolic function, independent of loading conditions and taking all myocardial segments into account. The aim of the study was to evaluate the prevalence of diastolic dysfunction in chronic dialysis patients using this novel technique, and to identify its determinants among clinical and echocardiographic variables. Methods. Patients currently enrolled in the ICD2 study protocol were included for this analysis. Next to conventional echo measurements diastolic function was also assessed by global diastolic strain rate during isovolumic relaxation (SRIVR). Results. A total of 77 patients were included (age 67±8 years, 74% male). When defined as E/SRIVR ≥236, the prevalence of diastolic dysfunction was higher compared to more conventional measurements (48% versus 39%). Left ventricular mass (OR 1.02, 95% CI 1.00–1.04, P=0.014) and pulse wave velocity (OR 1.34, 95% CI 1.07–1.68, P=0.01) were independent determinants of diastolic dysfunction. Conclusion. Diastolic dysfunction is highly prevalent among dialysis patients and might be underestimated using conventional measurements. Left ventricular mass and pulse wave velocity were the only determinants of diastolic dysfunction in these patients.
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spelling doaj-art-9bd311c7fda14ab792f3ea8ba93d60722025-08-20T03:37:31ZengWileyInternational Journal of Nephrology2090-214X2090-21582012-01-01201210.1155/2012/963504963504Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and DeterminantsMihály K. de Bie0Nina Ajmone Marsan1André Gaasbeek2Jeroen J. Bax3Marc Groeneveld4Bas A. Gabreels5Victoria Delgado6Ton J. Rabelink7Martin J. Schalij8J. Wouter Jukema9Department of Cardiology, Leiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Cardiology, Leiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Nephrology, Leiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Cardiology, Leiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Nephrology, Medisch Centrum Haagland, 2125 VA, The Hague, The NetherlandsDepartment of Nephrology, Rijnland Ziekenhuis, Leiderdorp, The NetherlandsDepartment of Cardiology, Leiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Nephrology, Leiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Cardiology, Leiden University Medical Center, 2300 RC Leiden, The NetherlandsDepartment of Cardiology, Leiden University Medical Center, 2300 RC Leiden, The NetherlandsBackground. Diastolic dysfunction is common among dialysis patients and is associated with increased morbidity and mortality. Novel echocardiographic speckle tracking strain analysis permits accurate assessment of left ventricular diastolic function, independent of loading conditions and taking all myocardial segments into account. The aim of the study was to evaluate the prevalence of diastolic dysfunction in chronic dialysis patients using this novel technique, and to identify its determinants among clinical and echocardiographic variables. Methods. Patients currently enrolled in the ICD2 study protocol were included for this analysis. Next to conventional echo measurements diastolic function was also assessed by global diastolic strain rate during isovolumic relaxation (SRIVR). Results. A total of 77 patients were included (age 67±8 years, 74% male). When defined as E/SRIVR ≥236, the prevalence of diastolic dysfunction was higher compared to more conventional measurements (48% versus 39%). Left ventricular mass (OR 1.02, 95% CI 1.00–1.04, P=0.014) and pulse wave velocity (OR 1.34, 95% CI 1.07–1.68, P=0.01) were independent determinants of diastolic dysfunction. Conclusion. Diastolic dysfunction is highly prevalent among dialysis patients and might be underestimated using conventional measurements. Left ventricular mass and pulse wave velocity were the only determinants of diastolic dysfunction in these patients.http://dx.doi.org/10.1155/2012/963504
spellingShingle Mihály K. de Bie
Nina Ajmone Marsan
André Gaasbeek
Jeroen J. Bax
Marc Groeneveld
Bas A. Gabreels
Victoria Delgado
Ton J. Rabelink
Martin J. Schalij
J. Wouter Jukema
Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and Determinants
International Journal of Nephrology
title Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and Determinants
title_full Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and Determinants
title_fullStr Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and Determinants
title_full_unstemmed Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and Determinants
title_short Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and Determinants
title_sort left ventricular diastolic dysfunction in dialysis patients assessed by novel speckle tracking strain rate analysis prevalence and determinants
url http://dx.doi.org/10.1155/2012/963504
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