Prevalência e impacto prognóstico da disfunção diastólica na doença renal crônica em hemodiálise

Barberato, Sílvio Henrique; Bucharles, Sérgio Gardano Elias; Sousa, Admar M.; Costantini, Costantino O.; Costantini, Costantino; Pécoits-Filho, Roberto

doi:10.1590/s0066-782x2010005000016

Cited by 34 publications

(17 citation statements)

References 25 publications

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“…LV diastolic dysfunction is the important determinant for the incidence of cardiovascular events [27]. In the present study, patients with an E/E′ ratio >15 showed lower ejection fraction and a higher percentage of CAD history compared to patients with an E/E′ ratio <15.…”

Section: Discussionsupporting

confidence: 47%

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

An¹,

Lee²,

Park³

et al. 2012

Kidney Blood Press Res

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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.

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Section: Discussionsupporting

confidence: 47%

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

An¹,

Lee²,

Park³

et al. 2012

Kidney Blood Press Res

View full text Add to dashboard Cite

show abstract

“…Studies carried out in hemodialysis patients showed that the prevalence of diastolic dysfunction in this population can vary from 63.5% to 87%, depending on the criteria used for definition and patients included in the sample [36][37][38] . Diastolic dysfunction is characterized by alterations in ventricular relaxation and compliance 5 and its high prevalence can be explained by the fact that the CKD expose the heart to pressure and volume overload and associated hemodynamic factors that cause myocardial alterations 39 .…”

Section: Siqueira Et Al Doppler Echocardiogram In Hemodialysis Patientsmentioning

confidence: 99%

“…In a recently published study, which evaluated 129 hemodialysis patients and the used conventional Doppler and tissue Doppler criteria to classify diastolic dysfunction, Barberato et al 37 showed that overall mortality was significantly higher in patients with diastolic dysfunction with pseudonormal pattern and restrictive flow, when compared to the group with diastolic dysfunction and abnormal relaxation or normal diastolic function. In this study, advanced diastolic dysfunction was showed to be an independent predictor of cardiovascular events.…”

Section: Siqueira Et Al Doppler Echocardiogram In Hemodialysis Patientsmentioning

confidence: 99%

Parâmetros ecocardiográficos como preditores de eventos cardiovasculares em pacientes em hemodiálise

Siqueira¹,

Ferreira²,

Júnior³

et al. 2012

Arq. Bras. Cardiol.

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“…DD is a common echocardiographic finding in HD patients, as well of in the early stages of CKD [16]. It has been associated with hypertension and left ventricle hypertrophy, and the consequences include intradialytic hypotension and death over-risk [29]. Different strategies have been developed to diminish DD and thus mortality and CVEs.…”

Section: Discussionmentioning

confidence: 99%

Diastolic Dysfunction and High Levels of New Cardiac Biomarkers as Risk Factors for Cardiovascular Events and Mortality in Hemodialysis Patients

et al. 2013

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Background/Aims: Cardiovascular events (CVEs) are the most frequent cause of death in hemodialysis (HD). We aim to determine cardiovascular and mortality risk factors. Methods: A historical cohort study was made of 211 prevalent HD patients [73 (60-80) years, 58% males] between 2005 and 2012. Demographic, laboratory test and echocardiographic values were recorded. During follow-up, CVEs and mortality were documented and analyzed. Results: 94 patients suffered a CVE. Age, history of cardiovascular disease (CVD), peripheral vascular disease, cardiac markers, systolic and diastolic dysfunction (DD) were associated to CVEs. Low albumin (RR 0.414, p = 0.002), DD (1.876, p = 0.038) and previous CVD (3.723, p < 0.001) were identified as independent predictors of CVEs. 98 patients died. Age, a history of CVD, peripheral vascular disease, cardiac markers, DD, dialysis vintage, and a vascular access different from autologous fistulae were associated to mortality. Low albumin (RR 0.499, p = 0.046), DD (RR 2.414, p = 0.017) and a vascular access different from autologous fistulae (RR 2.058, p = 0.034) were independent predictors of mortality. Conclusions: DD is an emergent risk factor for death and CVEs in dialysis. Low albumin is also a predictor for CVE. Non-autologous fistulae and low albumin are predictors for death. Nt-proBNP and hsTnT offer good information for identifying high-risk patients, but they do not predict events independently as they are only cardiac damage markers.

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Prevalência e impacto prognóstico da disfunção diastólica na doença renal crônica em hemodiálise

Abstract: Background: Diastolic dysfunction (DD) is frequent in patients on hemodialysis (HD), but its impact on the clinical evolution is yet to be established.

Cited by 34 publications

References 25 publications

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

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

Parâmetros ecocardiográficos como preditores de eventos cardiovasculares em pacientes em hemodiálise

Diastolic Dysfunction and High Levels of New Cardiac Biomarkers as Risk Factors for Cardiovascular Events and Mortality in Hemodialysis Patients

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