Abstract 15353: Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and Determinants
Introduction: Diastolic dysfunction is common among dialysis patients and is associated with increased morbidity and mortality. Novel echocardiographic speckle tracking strain analysis permits accurate assessment of left ventricular (LV) diastolic function, independent of loading conditions and taking all myocardial segments into account. The aim of the study was to evaluate the prevalence of diastolic dysfunction in chronic dialysis patients using this novel technique, and to identify its determinants among clinical and echocardiographic variables.
Methods: Patients currently enrolled in the ICD2 study protocol were included for this analysis. Next to conventional echo measurements diastolic function was also assessed by global diastolic strain rate during isovolumic relaxation (SRIVR). The presence of diastolic dysfunction was assessed using a previously defined cut-of: E/SRIVR ≥ 236. Following the determinants of diastolic dysfunction were identified among the baseline clinical parameters.
Results: A total of 77 patients were included (age 67±8 years, 74% male). When defined as E/SRIVR ≥ 236, the prevalence of diastolic dysfunction was higher compared to more conventional measurements (48% vs. 39%). Multiple regression analysis demonstrated that left ventricular mass (OR 1.02, 95% CI 1.01 - 1.04, p=0.01) and pulse wave velocity (OR 1.31, 95% CI 1.05-1.79) were independent determinants of diastolic dysfunction. See figure 1.
Conclusion: Diastolic dysfunction is highly prevalent among dialysis patients with preserved ejection fraction and might be underestimated using conventional measurements. Among baseline clinical and echocardiographic parameters left ventricular mass and pulse wave velocity were the only determinants of diastolic dysfunction in these patients.
- © 2011 by American Heart Association, Inc.