Evaluation of left ventricular diastolic function in nonhypertensive nondiabetic hemodialysis patients

Abstract

Diastolic dysfunction (DD) is common in hemodialysis (HD) patients. Because diabetes mellitus (DM) and hypertension (HT) are also common in this patient group, the exact reason for DD in HD patients is not clear. The present study evaluated left ventricular (LV) diastolic function in HD patients without DM and HT. Fifty patients on HD and 34 age-matched and sex-matched healthy control individuals were enrolled. Echocardiography was performed in all participants. LV systolic and diastolic functions were evaluated by B-mode echocardiography, pulsed wave, and tissue Doppler imaging. The HD patients were divided into two groups according to the presence or absence of left ventricular hypertrophy (LVH) in echocardiography. LV dimensions and systolic function were within normal limits and similar between groups. However, the HD patients had significantly worse diastolic function (E/A: 0.78 ± 0.26 vs. 1.19 ± 0.28, P < 0.001, e'/a' septal: 0.77 ± 0.36 vs. 1.04 ± 0.21, P < 0.001) and increased filling pressure (E/e': 8.55 ± 3.2 vs. 5.79 ± 1.93, P < 0.001). Thirty-one (62%) patients had LVH, whereas 19 (38%) patients did not have LVH. LV systolic and diastolic functions were similar in HD patients with and without LVH. Seventeen (55%) hypertrophies were concentric and 14 (45%) were eccentric. Diastolic functions were similar in patients with either concentric or eccentric hypertrophy. Diastolic function is impaired in HD patients even in the absence of diseases that can cause DD such as HT and DM.