Assessment of Left Ventricle Diastolic Dysfunction in Chronic Kidney Disease Patients

Abstract

Cardiovascular disease (CVD) remains the most common aetiology of mortality in chronic kidney disease (CKD). We aimed to assess the prevalence and quantify the relation of left ventricle (LV) diastolic dysfunction and CKD. A Prospective study carried on 100 patients (ages: 20-86 years) with CKD, divided into 4 groups according to their estimated glomerular filteration rate (eGFR): i) Group 1: GFR=60-89 (12 patients), ii) Group 2: GFR=30 – 59 (33 patients), iii) Group 3: GFR=15 – 29 (33 patients) and iv) Group 4: GFR < 15 or on dialysis (22 patients) and 20 healthy subjects (ages: 50-75 years) as control group refered to our department for routine evaluation during the period from October 2017 to June 2018. We performed conventional pulsed wave Doppler (cPWD) echocardiography and tissue Doppler imaging (TDI) to all patients. We reported significant prevalence of grade II & III LV diastolic dysfunction among group 3 and 4 CKD patients (p<0.001), concerning correlation between GFR and echocardiographic parameters in the study population; there was significant direct correlation between GFR and E/MED E' (R: 0.42; P<0.001) and Lat E' (R: 0.30; P=0.001), While there was significant inverse correlation between GFR and LA size (R: -0.21; P=0.018), E/A (R: -0.19; P=0.029), E (R: -0.49; P<0.001), E/LAT E'(R: -0.53; P<0.001) and grades of diastolic dysfunction (R: -0.54; P<0.001). In conclusion: LV diastolic dysfunction is strongly associated and directly related to chronic kidney disease grades.