Key result
Elevated E/E' ratio linked to ~10% higher mortality risk in peritoneal dialysis patients.
Why the study?
Left ventricular diastolic dysfunction is associated with cardiovascular complications and poor prognosis in chronic kidney disease patients on dialysis, but whether E/E'-defined diastolic dysfunction affects adverse outcomes in peritoneal dialysis patients required investigation.
Does a higher E/E' ratio predict adverse outcomes such as overall death and heart failure in peritoneal dialysis patients?
Cohort (n=148)
No
Does a higher E/E' ratio predict adverse outcomes such as overall death and heart failure in peritoneal dialysis patients?
Hazard Ratio: 1.1 (95% CI 1.1–1.2)
Absolute Event Rate: 38.5% vs 19.8%
p-value: p=0.047
An elevated E/E' ratio is an independent predictor of overall mortality and heart failure in patients undergoing peritoneal dialysis, highlighting the importance of monitoring diastolic function in this population.
Left ventricular diastolic dysfunction (LVDD) is an early event associated with cardiovascular complications and poor prognosis in chronic kidney disease patients undergoing dialysis. In this study, we investigated whether diastolic dysfunction, measured by the E/E' ratio, affects adverse outcomes in peritoneal dialysis (PD) patients (n = 148). Our results showed that patients with an E/E' ratio ≥ 15 were more likely to be female, have a longer dialysis vintage, have significantly higher left atrial volume index and left atrial kinetic energy levels, have lower E' levels and LV hypertrophy (LVH) degree, and have higher volume markers. Kaplan-Meier curves revealed that patients with a higher E/E' ratio had worse survival and a higher risk of heart failure than those with a lower E/E' ratio. Subgroup analysis demonstrated that non-diabetic patients with a higher E/E' ratio had a higher risk of heart failure than those with a lower E/E' ratio. Cox proportional hazard regression analysis indicated that the ECW/ICW ratio was strongly associated with LVDD and confirmed that the E/E' ratio was an independent risk factor for overall death. Our study suggests that monitoring the E/E' ratio in PD patients is important for improving their prognosis.
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Xiang et al. (2023) conducted a cohort in Peritoneal dialysis (n=148). Elevated E/E' ratio (≥ 15) vs. Normal E/E' ratio (< 15) was evaluated on All-cause mortality (HR 1.1, 95% CI 1.1-1.2, p=0.047). In peritoneal dialysis patients, an elevated E/E' ratio (≥ 15) was associated with a significantly higher risk of all-cause mortality (38.5% vs 19.8%), and the E/E' ratio was an independent risk factor for death (HR 1.1).
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