Association between Diastolic Dysfunction by Color Tissue Doppler Imaging and Vascular Calcification on Plain Radiographs in Dialysis Patients

Abstract

Background/Aim: Diastolic dysfunction is frequently associated with left ventricular hypertrophy, which is indicative of future cardiovascular events. Vascular calcification (VC) is known to be associated with coronary artery disease in dialysis patients. The present study was to determine the interrelationship between LV diastolic dysfunction by tissue Doppler imaging and VC on plain radiographs in dialysis patients. Methods: Fifty-six dialysis patients were recruited and VC scores were evaluated by plain radiographic film. The ratio of early diastolic transmitral inflow velocity (E) to early diastolic mitral annular velocity (E′) was measured by tissue Doppler imaging. We defined diastolic dysfunction as an E/E′ ratio >15 on tissue Doppler imaging. Results: Patients with diastolic dysfunction showed a higher percentage of coronary artery disease history, abdominal aortic calcification (AAC) scores ≥5, high LV mass index, and high left atrium volume compared to patients without diastolic dysfunction. The E/E′ ratio was significantly higher in patients with significant VC, VC scores of the pelvis and hands ≥3, and AAC scores ≥5 on plain radiographs. AAC scores ≥5 were considered an independent predictor of diastolic dysfunction. Conclusion: VC on plain radiographs is associated with the E/E′ ratio and AAC scores ≥5 are important clues for LV diastolic dysfunction in dialysis patients.