Abstract 15869: Correlation between Renal Insufficiency and Diastolic Dysfunction
Background: The chronic kidney disease is a major risk factor for CAD and left ventricle systolic dysfunction. However, studies regarding its association with diastolic dysfunction (DD) are lacking.
Objective: We aimed to investigate whether renal insufficiency (RI) is associated with DD among patients with left ventricular ejection fraction (LVEF) > 50%, and to investigate whether there is a correlation between RI and DD severity.
Methods: In this observational retrospective study, we reviewed the echocardiograms of patients who presented to ambulatory clinics of a tertiary academic medical center. Study population included 1329 DD patients with LVEF>50% and 308 randomly selected normal controls. Demographic and clinical variables were compared between patients with DD and normal controls. Patients with impaired relaxation (grade I) were compared to those with pseudonormal (grade II) or restrictive (grade III) DD. RI was defined as estimated glomerular filtration rate (eGFR) < 60mL/min/1.73 m2, within 6 months prior to the echocardiogram. Student’s t-test and chi-square were used for univariable analysis. We utilized logistic regression analysis with a forward hierarchical variable selection strategy to investigate independent correlation of RI with DD and its severity.
Results: Overall, 51.8% of the participants were female and 28.8% had RI. Among 1329 patients with DD, 1238 (93.2%) had grade I, & 91 (6.8%) had grade II or III. Prevalence of RI among patients with any degree of DD was 30.8%, compared to 12.4% among normal controls (Odds ratio [OR]: 2.9, 95%CI: 2.1, 4.8, p<0.001). Similarly, DD patients had lower GFR compared to controls (76.9 vs. 95.3, p<0.001). In the multivariable analysis, the final model showed that after adjusting for age, sex, hypertension, and DM, RI is an independent correlate of DD (OR: 1.9, 95%CI: 1.1, 4.5, p=0.023). The same pattern was observed comparing the frequency of RI (45.3% vs. 25.9%, OR: 2.2, 95%CI: 1.4, 2.9, p=0.005) and level of GFR (83.5 vs. 64.8, p=0.002) in patients with grade I DD & those with grade II or higher.
Conclusion: Our Study indicated a clear and independent association between RI and DD. The severity of RI also tends to correlate with the severity of DD.
- © 2012 by American Heart Association, Inc.