Abstract: FR-PO475

Relationships between CKD and Progression of Left Ventricular Diastolic Dysfunction

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

  • Miyajima, Yoshiyasu, Kanazawa University Hospital, Kanazawa, Japan
  • Toyama, Tadashi, Kanazawa University Hospital, Kanazawa, Japan
  • Kitajima, Shinji, Kanazawa University Hospital, Kanazawa, Japan
  • Hara, Akinori, Kanazawa University Hospital, Kanazawa, Japan
  • Iwata, Yasunori, Kanazawa University Hospital, Kanazawa, Japan
  • Sakai, Norihiko, Kanazawa University Hospital, Kanazawa, Japan
  • Shimizu, Miho, Kanazawa University Hospital, Kanazawa, Japan
  • Furuichi, Kengo, Kanazawa University Hospital, Kanazawa, Japan
  • Wada, Takashi, Kanazawa University Hospital, Kanazawa, Japan
Background

CKD is known as a risk factor for heart failure, but its role on the left ventricular diastolic dysfunction as a preliminary stage of heart failure has not been adequately studied.

Methods

To investigate the relationship between CKD and progression of left ventricular diastolic dysfunction, we included patients who received echocardiography examination in Kanazawa University Hospital for more than twice with intervals of more than one year. We excluded clinically diagnosed coronary artery disease, moderate valvular heart disorder and structural heart disease. Patients were examined their left ventricular peak velocity of blood flow across the mitral valve (E) and their diastolic peak velocities of mitral annulus (e'); E/e’ ratio was used as an index of left ventricular diastolic function, and E/e’ ratio >14 was defined as left ventricular diastolic dysfunction. Baseline estimated glomerular filtration rate (eGFR) and dipstick proteinuria were used as a status of chronic kidney disease (CKD). Time to development of left ventricular diastolic dysfunction and baseline CKD status were assessed using Cox proportional hazard models adjusted for known risk factors.

Results

A total of 1,163 subjects were included and the average observation period was 3.2 years. Compared to the patients with the estimated GFR ≥90 mL/min/1.73 m2 as a reference, hazard ratios (95% confidence intervals) for the development of diastolic dysfunction were 1.25 (0.87–1.79), 1.51 (0.96–2.38), 2.06 (1.25–3.40), and 3.54 (2.13–5.88) for patients with eGFR 60–89 mL/min/1.73 m2, 45–59 mL/min/1.73 m2, 30–44 mL/min/1.73 m2, <30 mL/min/1.73 m2, respectively. Compared to patients with proteinuria – or trace, patients with proteinuria more than 2+ or more were also a significant risk factor (hazard ratio 2.15, 95% confidence interval 1.40–3.29).

Conclusion

Low GFR and proteinuria were risk factors for the development of left ventricular diastolic dysfunction.