Impaired renal function is a major determinant of left ventricular diastolic dysfunction: assessment by stress myocardial perfusion imaging

Sato, Wakana; Kosaka, Toshimitsu; Koyama, Takashi; Ishida, Masaru; Iino, Kenji; Watanabe, Hiroyuki; Itoh, Hiroshi

doi:10.1007/s12149-013-0739-z

Cited by 9 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Left ventricular diastolic dysfunction occurs frequently in CKD patients. In addition to the effect of increase in LV preload, other factors such as over‐activation of the rennin‐angiotensin‐aldosterone system (RAAS), LV hypertrophy, altered fluid and electrolyte, microvascular abnormalities, metabolism, and neurohumoral alterations might play important roles in the development of LVDD in CKD patients . Preload‐dependent Doppler techniques are known to underestimate the degree of LVDD in hemodialysis patients .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction

Wang

Chen

et al. 2019

Echocardiography

View full text Add to dashboard Cite

Background Intra‐ventricular blood flow dynamics is considered as an important component of left ventricular (LV) function assessment. The purpose of this study was to evaluate the LV diastolic function in chronic kidney disease (CKD) with different degrees of LV diastolic dysfunction (LVDD) by using flow energetic parameters. Methods In this study, a total of 96 cases were recruited, including 58 CKD patients and 38 healthy controls. CKD patients were divided into 2 groups according to LVDD severity, named as DD1 and DD2. Vector flow‐mapping (VFM) analysis was executed to calculate left ventricle average energy loss (EL) during early filling phase (E‐EL_ave), atrial filling phase (A‐EL_ave), diastole phase (D‐EL_ave), and ejection phase (S‐EL_ave). Moreover, the average vortex circulation during early filling phase (E‐cir_ave) and atrial filling phase (A‐cir_ave) was also assessed in the apical three‐chamber view. The rate of average EL during early filling and atrial filling was expressed as E/A‐EL. Result Compared to the control group, A‐EL_ave, S‐EL_ave, and A‐cir_ave in the DD1 group were higher (P < 0.05), and all parameters were obviously higher in the DD2 group (P < 0.05). In the control group and the DD2 subgroup, the E‐EL_ave value was significantly higher than A‐EL_ave value, which was opposite to the DD1 group. As diastolic dysfunction worsened, E‐EL_ave and D‐EL_ave risen gradually (P < 0.05), and A‐EL_ave and S‐EL_ave were slightly elevated with no significance. There were significant correlations between LV diastolic function and flow energetic parameters. Stepwise multiple regression analysis revealed that various LV function parameters could be regarded as independent predictors of average diastolic EL (all P < 0.01). Conclusions For CKD patient with LVDD and LVEF > 50%, effective LV filling and systolic ejection with optimized energy consumption have been impaired. As a new flow‐derived index, EL can quantitatively evaluate LV diastolic function in terms of blood fluid dynamics in CKD with various LVDD.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction

Wang

Chen

et al. 2019

Echocardiography

View full text Add to dashboard Cite

show abstract

“…According to studies, it may be influenced by the increase in LV preload due to progression of CKD stage [ 10 ]. Also LV hypertrophy, CAD, microvascular abnormalities, interstitial fibrosis, altered fluid and electrolyte metabolism and neurohumoral alterations might contribute to the development of LV diastolic dysfunction in patients with CKD [ 11 ]. Over-activation of the rennin–angiotensin–aldosterone system (RAAS) might play an important role in the pathomechanism since even a mild CKD results in early cardiac fibrosis with mild LV diastolic impairment and preserved systolic function [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Heart function disturbances in chronic kidney disease – echocardiographic indices

Franczyk¹,

Gluba²,

Olszewski³

et al. 2014

aoms

View full text Add to dashboard Cite

IntroductionIn chronic kidney disease (CKD) patients left ventricular (LV) diastolic dysfunction occurs frequently and is associated with heart failure (HF) and higher mortality. Left ventricular systolic dysfunction is associated with coronary artery disease (CAD) and is a major determinant of prognosis. The aim of this study was to assess indices of LV diastolic dysfunction in CKD patients.Material and methodsStudy included 118 CKD patients. All patients underwent transthoracic echocardiography. Diastolic function based on E and A, E/A ratio and pulmonary vein flow velocities as well as EF%, deceleration time, RA, LA volume were assessed. In dialysis patients examination was carried out before and after dialysis.ResultsIn CKD patients the stage of renal failure was associated with the significant increase in LV mass (268.0 ±47.6 CKD I/II vs. 432.7 ±122.4 CKD V/dialysis, p < 0.0001), systolic LV (37.3 ±4.5 vs. 51.2 ±8.9, p < 0.0001) and diastolic LV (CKD I–II 44.7 ±4.1 vs. CKD III 48.5 ±6.7 vs. CKD IV 47.1 ±5.6; p = 0.004) dimensions and in the size of the LA (40.4 ±2.0 vs. 41.9 ±2.7 vs. 42.3 ±3.2 vs. 44.8 ±3.1; p < 0.0001). The increase the E/E’ ratio between groups of patients (6.7 ±1.5 vs. 8.9 ±2.4 vs. 11.5 ±4.0 vs. 13.5 ±5.0; p < 0.0001) was seen in this study. The reduction in deceleration time (247.2 ±34.5 in CKD I/II vs. 197.4 ±61.0 in CKD IV, p = 0.0005) along with the decrease in estimated glomerular filtration rate was also observed in this study.ConclusionsEarly identification of factors involved is necessary to prevent this devastating process. Many indexes of contractility are used and each of them has imperfections. It seems that TVI, E, E/A and E/E’ are good instruments for the early detection of left ventricular hypertrophy and diastolic dysfunction.

show abstract

“…Heart failure itself is associated with high risk of renal dysfunction and development of CKD . Conversely, poor renal function has been shown to predict left ventricle (LV) dysfunction . This means that the onset of CKD is a risk factor for the subsequent development of heart failure .…”

Section: Relationship Between Heart Failure and Renal Failurementioning

confidence: 99%

Renal function monitoring in heart failure – what is the optimal frequency? A narrative review

Al-Naher

Wright

Devonald

et al. 2017

Brit J Clinical Pharma

View full text Add to dashboard Cite

The second most common cause of hospitalization due to adverse drug reactions in the UK is renal dysfunction due to diuretics, particularly in patients with heart failure, where diuretic therapy is a mainstay of treatment regimens. Therefore, the optimal frequency for monitoring renal function in these patients is an important consideration for preventing renal failure and hospitalization. This review looks at the current evidence for optimal monitoring practices of renal function in patients with heart failure according to national and international guidelines on the management of heart failure (AHA/NICE/ESC/SIGN). Current guidance of renal function monitoring is in large part based on expert opinion, with a lack of clinical studies that have specifically evaluated the optimal frequency of renal function monitoring in patients with heart failure. Furthermore, there is variability between guidelines, and recommendations are typically nonspecific. Safer prescribing of diuretics in combination with other antiheart failure treatments requires better evidence for frequency of renal function monitoring. We suggest developing more personalized monitoring rather than from the current medication‐based guidance. Such flexible clinical guidelines could be implemented using intelligent clinical decision support systems. Personalized renal function monitoring would be more effective in preventing renal decline, rather than reacting to it.

show abstract

Impaired renal function is a major determinant of left ventricular diastolic dysfunction: assessment by stress myocardial perfusion imaging

Cited by 9 publications

References 27 publications

Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction

Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction

Heart function disturbances in chronic kidney disease – echocardiographic indices

Renal function monitoring in heart failure – what is the optimal frequency? A narrative review

Contact Info

Product

Resources

About