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Diastolic dysfunction is an independent predictor of cardiovascular events in incident dialysis patients with preserved systolic function

Authors
 Jae Hyun Han  ;  Ji Suk Han  ;  Eun Jin Kim  ;  Fa Mee Doh  ;  Hyang Mo Koo  ;  Chan Ho Kim  ;  Mi Jung Lee  ;  Hyung Jung Oh  ;  Jung Tak Park  ;  Seung Hyeok Han  ;  Dong-Ryeol Ryu  ;  Tae-Hyun Yoo  ;  Shin-Wook Kang 
Citation
 PLoS One, Vol.10(3) : e0118694, 2015 
Journal Title
 PLoS One 
ISSN
 1932-6203 
Issue Date
2015
Abstract
BACKGROUND: Diastolic heart failure (HF), the prevalence of which is gradually increasing, is associated with cardiovascular (CV) morbidity and mortality in the general population and, more specifically, in patients with end-stage renal disease (ESRD). However, the impact of diastolic dysfunction on CV outcomes has not been studied in incident dialysis patients with preserved systolic function. METHODS: This prospective observational cohort study investigates the clinical consequence of diastolic dysfunction and the predictive power of diastolic echocardiographic parameters for CV events in 194 incident ESRD patients with normal or near normal systolic function, who started dialysis between July 2008 and August 2012. RESULTS: During a mean follow-up duration of 27.2 months, 57 patients (29.4%) experienced CV events. Compared to the CV event-free group, patients with CV events had a significantly higher left ventricular (LV) mass index, ratio of early mitral flow velocity (E) to early mitral annulus velocity (E') (E/E'), LA volume index (LAVI), deceleration time, and right ventricular systolic pressure, and a significantly lower LV ejection fraction and E'. In multivariate Cox proportional hazard analysis, E/E'>15 and LAVI>32 mL/m2 significantly predicted CV events (E/E'>15: hazard ratio [HR] = 5.40, 95% confidence interval [CI] = 2.73-10.70, P< .001; LAVI>32 mL/m2: HR = 5.56, 95% CI = 2.28-13.59, P< .001]. Kaplan-Meier analysis revealed that patients with both E/E'>15 and LAVI>32 mL/m2 had the worst CV outcomes. CONCLUSION: An increase in E/E' or LAVI is a significant risk factor for CV events in incident dialysis patients with preserved LV systolic function.
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DOI
10.1371/journal.pone.0118694
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
구향모(Koo, Hyang Mo)
김은진(Kim, Eun Jin)
김찬호(Kim, Chan Ho)
도화미(Doh, Fa Mee) ORCID logo https://orcid.org/0000-0002-4780-6728
류동열(Ryu, Dong Ryeol)
박정탁(Park, Jung Tak) ORCID logo https://orcid.org/0000-0002-2325-8982
오형중(Oh, Hyung Jung)
유태현(Yoo, Tae Hyun) ORCID logo https://orcid.org/0000-0002-9183-4507
이미정(Lee, Mi Jung)
한승혁(Han, Seung Hyeok) ORCID logo https://orcid.org/0000-0001-7923-5635
한재현(Han, Jae Hyun)
한지숙(Hahn, Jee Sook)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139658
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