Key result
Left ventricular diastolic dysfunction was independently associated with increased risks of major adverse cardiovascular events (HR 1.71; 95% CI 1.43-3.51) and mortality in peritoneal dialysis patients.
Why the study?
Does left ventricular diastolic dysfunction predict major adverse cardiovascular events and mortality in patients undergoing peritoneal dialysis with preserved systolic function?
Cohort (n=149)
Does left ventricular diastolic dysfunction predict major adverse cardiovascular events and mortality in patients undergoing peritoneal dialysis with preserved systolic function?
Hazard Ratio: 1.71 (95% CI 1.43–3.51)
p-value: p=0.02
In patients undergoing peritoneal dialysis with preserved systolic function, left ventricular diastolic dysfunction is an independent predictor of future MACE and mortality.
May aid risk stratification in peritoneal dialysis; leaves open whether targeting diastolic dysfunction improves outcomes.
Left ventricular diastolic dysfunction (LVDD) is common among patients undergoing peritoneal dialysis (PD). We examined the relationship between LVDD, major adverse cardiovascular events (MACE), and mortality in PD patients. A total of 149 patients undergoing PD with preserved left ventricular systolic function were included and followed for 3.5 years. LVDD was diagnosed (according to the European Society of Cardiology guidelines) by conventional and tissue Doppler echocardiography. Serum high-sensitivity C-reactive protein (hsCRP) was measured. The location and volume of adipose tissue were assessed by computed tomography (CT) at the level of the fourth lumbar vertebra. Subjects with LVDD had higher levels of hsCRP, and more visceral and peritoneal fat than controls. The relationship between adjusted visceral adipose tissue and LVDD became nonsignificant when hsCRP and baseline demographic data were introduced into the logistic regression model (odds ratio = 1.52, P = 0.07). Subsequent hierarchical multivariate Cox regression analysis showed that LVDD was one of the most powerful determinants of MACE and mortality after adjusting for all confounding factors (hazard ratio [HR]: 1.71, 95% confidence interval [CI]: 1.43-3.51, P = 0.02 and HR: 2.25, 95% CI: 1.45-2.91, P = 0.04, respectively). Systemic inflammation (hsCRP) was also significantly associated with MACE and mortality (HR: 2.03, P = 0.03 and HR: 2.16, P = 0.04, respectively). LVDD is associated with systemic inflammation and increased visceral fat in patients undergoing PD. LVDD is also a sensitive, independent indicator of future MACE and mortality in PD patients.
No takes yet. Share an insight, caveat, or question.
Wu et al. (2015) conducted a cohort in Peritoneal dialysis (n=149). Left ventricular diastolic dysfunction (LVDD) vs. Patients without LVDD was evaluated on Major adverse cardiovascular events (MACE) (HR 1.71, 95% CI 1.43-3.51, p=0.02). Left ventricular diastolic dysfunction was independently associated with increased risks of major adverse cardiovascular events (HR 1.71; 95% CI 1.43-3.51) and mortality in peritoneal dialysis patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: