Assessment of Left Ventricle Diastolic Dysfunction in Chronic Kidney Disease Patients

Introduction: Cardiovascular disease (CVD) remains the most common cause of mortality in chronic kidney disease (CKD). Objective: to determine the prevalence and quantify the relation of LV diastolic dysfunction and CKD. Methods: Prospective study carried on 100 patients (ages: 20-86 years) with CKD, divided into 4 groups according to their estimated glomerular filtration rate (eGFR): i) Group 1: GFR= 60-89 (12 patients), ii) Group 2: GFR=30–59 (33 patients), iii) Group 3: GFR= 15–29 (33 patients) and iv) Group 4: GFR < 15 or on dialysis (22 patients) and 20 healthy subjects (ages: 50-75 years) as control group referred the department of Cardiology- Faculty of Medicine- Mansoura University, for routine evaluation during the period from October 2017 to June 2018. Conventional pulsed wave Doppler (cPWD) echocardiography and tissue Doppler imaging (TDI) were performed in all patients Results: Comparison of the 4 groups of CKD patients regarding grades of LV diastolic dysfunction; grades II & III, LV diastolic dysfunction were more prevalent among patients of group 3 and group 4 CKD patients (p < 0.001), concerning correlation between GFR and echocardiographic parameters in the study population; there was significant direct correlation between GFR and E/MED E' (R: 0.42; P<0.001) and Lat E' (R: 0.30; P=0.001), While there was significant inverse correlation between GFR and LA size (R: -0.21; P=0.018), E/A (R: -0.19; P=0.029), E(R: -0.49; P<0.001), E/LAT E'(R: -0.53; P<0.001) and grades of diastolic dysfunction (R: -0.54; P<0.001).Conclusion: LV diastolic dysfunction is an indicator of damage to the myocardium before heart failure becomes clinically apparent.