Volume markers in left ventricular diastolic dysfunction and adverse outcomes in peritoneal dialysis patients: a prospective cohort study

Abstract

Left ventricular diastolic dysfunction (LVDD) is an early event associated with cardiovascular complications and poor prognosis in chronic kidney disease patients undergoing dialysis. In this study, we investigated whether diastolic dysfunction, measured by the E/E′ ratio, affects adverse outcomes in peritoneal dialysis (PD) patients (n = 148). Our results showed that patients with an E/E′ ratio ≥ 15 were more likely to be female, have a longer dialysis vintage, have significantly higher left atrial volume index and left atrial kinetic energy levels, have lower E′ levels and LV hypertrophy (LVH) degree, and have higher volume markers. Kaplan–Meier curves revealed that patients with a higher E/E′ ratio had worse survival and a higher risk of heart failure than those with a lower E/E′ ratio. Subgroup analysis demonstrated that non-diabetic patients with a higher E/E′ ratio had a higher risk of heart failure than those with a lower E/E′ ratio. Cox proportional hazard regression analysis indicated that the ECW/ICW ratio was strongly associated with LVDD and confirmed that the E/E′ ratio was an independent risk factor for overall death. Our study suggests that monitoring the E/E′ ratio in PD patients is important for improving their prognosis.