Differential associations between glomerular filtration rate and duration of obesity depending on the presence or absence of left ventricular diastolic dysfunction

Ybarra, Juan; Sánchez-Hernández, Joan; Vilallonga, Ramón; Romeo, June Hart

doi:10.1016/j.ejim.2016.02.016

Cited by 3 publications

(5 citation statements)

References 43 publications

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“…In other words, LV diastolic function improved as patient renal function recovered after transplantation, but deteriorated when given a greater amount of fluid during surgery, especially in patients with underlying diastolic dysfunction. Such findings are consistent with previous studies stating the impact of renal function and hemodynamic volume status on LV diastolic function in patients with ESRD 222425. Our findings also coincide with the vulnerability of diastolic dysfunction on massive and acute fluid challenge during transplantation surgery, which is the type of surgery that is accompanied by extensive amounts of fluid administration over a relatively short period, and consequently aggravates diastolic function due to inadequate compensation.…”

Section: Discussionsupporting

confidence: 93%

The Impact of Perioperative Factors on Changes in Diastolic Function after Kidney Transplantation: A Retrospective Analysis

et al. 2019

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Purpose Cardiac changes in end-stage renal disease are the most common causes of death after kidney transplantation (KT). Chronic kidney disease presents a major risk factor for the development and progression of diastolic dysfunction. The purpose of this study was to identify the association between changes in left ventricular (LV) diastolic function and perioperative clinical factors in patients with preserved ejection fraction following KT. Materials and Methods We reviewed 115 patients who underwent KT between January 2011 and December 2015 with both preand post-transplant echocardiograms; patients with LV systolic dysfunction were excluded. LV diastolic function was measured using the ratio of early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/e′). Results Patients with normal pre-operative LV systolic function (n=97) showed improvement in E/e′ after KT (11.9±4.4 to 10.5±3.8, p =0.023). Additionally, post-KT estimated glomerular filtration ratio was associated with changes in E/e′ (odds ratio, −0.056; 95% confidence interval, −0.014 to −0.007; p =0.026). Among patients with preexisting diastolic dysfunction (20/97 patients), the amount of intraoperative fluid administration was related to E/e′ changes (odds ratio, 0.003; 95% confidence interval, 0.000 to 0.005; p =0.029). Conclusion KT is associated with improved diastolic function. Post-KT renal function was significantly related to changes in LV diastolic function. The amount of intraoperative fluid was a risk factor for worsening diastolic function after KT in patients with preexisting diastolic dysfunction.

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Section: Discussionsupporting

confidence: 93%

The Impact of Perioperative Factors on Changes in Diastolic Function after Kidney Transplantation: A Retrospective Analysis

et al. 2019

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“…The odds of incident CKD increased by 21% for each unit increment in BMI after adjustment for T2D, smoking, and baseline eGFR over 18 years in the Framingham Offspring Study [212]. Last, obesitymediated LVDD and the duration of obesity hastens the decline of renal function [175].…”

Section: Obesity Exposure Cardiac Remodeling and Cardiovascular Outcomesmentioning

confidence: 97%

“…In brief, obesity-related CKD undoubtedly accelerates the symptomatic decline in patients with HFpEF. Renal function correlates inversely with BMI and the duration of obesity and positively with LVDD [175]. When evolving rapidly, obesity-related kidney disease may underlie the premature development of HFpEF syndrome (Figure 3).…”

Section: Obesitymentioning

confidence: 99%

“…Further, the duration of morbid obesity is the strongest predictor of incident HFpEF in normotensive patients without overt cardiovascular disease [206]. Left ventricular diastolic dysfunction is congruent with long-lasting severe obesity and is associated with reduced eGFR [175]. Independently of a healthy or unhealthy status, the duration of severe obesity was a major risk of incident HF in the Nord-Trondelag Health (HUNT) study [207].…”

Section: Duration Of Obesity and Preserved Ejection Fraction Heart Fa...mentioning

confidence: 99%

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Obesity, Preserved Ejection Fraction Heart Failure, and Left Ventricular Remodeling

Stencel

Alai

Dhorepatil

et al. 2023

JCM

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Owing to the overwhelming obesity epidemic, preserved ejection fraction heart failure commonly ensues in patients with severe obesity and the obese phenotype of preserved ejection fraction heart failure is now commonplace in clinical practice. Severe obesity and preserved ejection fraction heart failure share congruent cardiovascular, immune, and renal derangements that make it difficult to ascertain whether the obese phenotype of preserved ejection fraction heart failure is the convergence of two highly prevalent conditions or severe obesity enables the development and progression of the syndrome of preserved ejection fraction heart failure. Nevertheless, the obese phenotype of preserved ejection fraction heart failure provides a unique opportunity to assess whether sustained and sizeable loss of excess body weight via metabolic bariatric surgery reverses the concentric left ventricular remodeling that patients with preserved ejection fraction heart failure commonly display.

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“…Obesity imposes hemodynamic changes that concomitantly affects the heart (diastolic dysfunction) and kidney (decreased GFR). 35 Thus, the inter-relation between T2D and its comorbidities (obesity, hypertension) on one hand and CRS on the other, is complex.…”

Section: Risk Factors and Pathogenetic Mechanismsmentioning

confidence: 99%

Heart Failure and Chronic Kidney Disease in Type 2 Diabetes

Cernea

2016

Journal of Interdisciplinary Medicine

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Complex hemodynamic, neurohormonal and biochemical changes occur in heart failure and chronic kidney disease, and hyperglycemia/diabetes further accentuate the multifactorial pathogenetic mechanisms. The acknowledgement of concomitant heart and kidney dysfunction in patients with type 2 diabetes has major clinical implications with regards to prognosis, as they significantly increase the risk of mortality, and to therapeutical strategy of both conditions, as well as of hyperglycemia. A comprehensive interdisciplinary approach is needed in these cases in order to improve the outcomes.

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Differential associations between glomerular filtration rate and duration of obesity depending on the presence or absence of left ventricular diastolic dysfunction

Cited by 3 publications

References 43 publications

The Impact of Perioperative Factors on Changes in Diastolic Function after Kidney Transplantation: A Retrospective Analysis

The Impact of Perioperative Factors on Changes in Diastolic Function after Kidney Transplantation: A Retrospective Analysis

Obesity, Preserved Ejection Fraction Heart Failure, and Left Ventricular Remodeling

Heart Failure and Chronic Kidney Disease in Type 2 Diabetes

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