Prevalence of left ventricular diastolic dysfunction by tissue doppler imaging in patients with end stage renal disease undergoing regular dialysis with preserved systolic function

Abstract

Patients with end-stage renal disease (ESRD) undergoing regular dialysis face a heightened risk of cardiovascular complications, with left ventricular (LV) diastolic dysfunction being a significant concern. Despite preserved systolic function, diastolic dysfunction can lead to notable morbidity. Tissue Doppler imaging (TDI) is a reliable noninvasive tool for assessing diastolic function. This study aims to investigate the prevalence and severity of LV diastolic dysfunction in ESRD patients undergoing regular dialysis with preserved systolic function. Methods: A cohort of 100 ESRD patients, each on dialysis for more than six months, was evaluated. Standard echocardiographic and TDI metrics were measured, including left ventricular ejection fraction (EF), E/A ratio, E/e’ ratio, and left atrial volume index (LAVI). Patients were classified into different grades of diastolic function according to the guidelines of the American Society of Echocardiography. Results: The study found that 78% of patients exhibited LV diastolic dysfunction, with 46% classified as grade I, 26% as grade II, and 6% as grade III. Significant correlations were observed between hemoglobin levels and both the E/e’ ratio (r = -0.29, p < 0.003) and LAVI (r = -0.23, p = 0.002). The E/e’ ratio demonstrated greater sensitivity (74.3%) for detecting diastolic dysfunction compared to the E/A ratio (28.2%) (p < 0.0001). Conclusion: LV diastolic dysfunction is highly prevalent in ESRD patients on regular dialysis, even when systolic function remains intact. TDI, and particularly the E/e’ ratio, is an invaluable tool for the early detection and management of diastolic dysfunction, allowing for better cardiovascular risk stratification in this population.

Imprint

Walid Mohamed Sallam, Ahmed A. Elkaialy, Magdy A. Gharieb, Sameh S. Thabet. Prevalence of left ventricular diastolic dysfunction by tissue doppler imaging in patients with end stage renal disease undergoing regular dialysis with preserved systolic function. Cardiometry; Issue 33; November 2024; p.87-94; DOI: 10.18137/cardiometry.2024.33.8794; Available from: https://www.cardiometry.net/issues/no33-november-2024/prevalence-left-ventricular-diastolic