Key result
Diastolic dysfunction affects ~87% of hemodialysis patients with preserved EF, worsening alongside atherosclerosis and calcification.
Why the study?
Is the severity of diastolic dysfunction associated with markers of atherosclerosis and vascular calcification in hemodialysis patients?
Observational (n=89)
Is the severity of diastolic dysfunction associated with markers of atherosclerosis and vascular calcification in hemodialysis patients?
In hemodialysis patients with preserved systolic function, the severity of diastolic dysfunction is strongly associated with the progression of atherosclerosis and vascular calcification as measured by CAVI, TBI, and ACAI.
Diastolic dysfunction severity was associated with vascular calcification markers in HD patients with preserved EF; hypothesis-generating for prospective trials.
Diastolic dysfunction (DD) commonly causes heart failure with preserved ejection fraction (EF). Here, we examine associations between DD severity and atherosclerosis/vascular calcification in hemodialysis patients. Echocardiography was performed on 101 patients undergoing hemodialysis therapy. Twelve patients (EF < 50% or chronic atrial fibrillation) were excluded; DD of the remaining 89 patients was classified into four grades. We then investigated the relationship between their DD grades and the cardio-ankle vascular index (CAVI), ankle-brachial pressure index (ABI), toe-brachial pressure index (TBI), and aortic calcification area index (ACAI). Seventy-seven patients (86.5%) with EF ≥ 50% had DD. Associations with advanced age and comorbid diabetes mellitus and cardiovascular disease were observed. The CAVI, TBI, and ACAI, but not ABI, increased proportionally with DD grades. Thus, many hemodialysis patients developed DD, with systolic function maintained. Strong associations between DD grades and progression of both atherosclerosis and vascular calcification could be inferred.
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Unagami et al. (2016) conducted an observational in Hemodialysis (n=89). Diastolic dysfunction grading was evaluated on Relationship between diastolic dysfunction grades and CAVI, ABI, TBI, and ACAI. Among hemodialysis patients with preserved ejection fraction, 86.5% had diastolic dysfunction, the severity of which increased proportionally with atherosclerosis and vascular calcification markers.
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