Left Ventricular Longitudinal Diastolic Function and Functional Reserve in ESRD Patients Starting Dialysis Treatment.
- Author:
Dong Ryeol RYU
1
;
Shin Wook KANG
;
Sung Ha PARK
;
Tae Hyun YOO
;
Hyung Jong KIM
;
Hoon Young CHOI
;
Joo Seong KIM
;
Seok Min KANG
;
Se Joong RIM
;
Namsik CHUNG
;
Jong Won HA
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Institute of Kidney Disease, Seoul, Korea. jwha@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Diastolic function;
Diastolic functional reserve;
Doppler tissue imaging;
End stage renal disease (ESRD)
- MeSH:
Dialysis*;
Diastole;
Echocardiography, Doppler;
Humans;
Kidney Failure, Chronic*;
Relaxation
- From:Korean Journal of Nephrology
2005;24(1):100-107
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Abnormalities of the left ventricular (LV) diastolic dysfunction are common in patients with end-stage renal disease (ESRD). Recently, Doppler tissue imaging (DTI) has been introduced as a method to evaluate diastolic function or myocardial relaxation by measuring mitral annulus velocity during diastole. This study was undertaken to assess resting diastolic function and diastolic functional reserve during exercise in ESRD patients starting dialysis treatment. METHODS: Mitral inflow velocities by Doppler echocardiography and septal mitral annular velocities by DTI were measured at rest and during supine bicycle exercise in 22 new ESRD patients and 23 age- and sex-matched subjects with normal renal function as a control. RESULTS: LV end-diastolic and end-systolic dimensions, septal thickness, and left atrial volume index were significantly higher in patients with ESRD compared with those of controls (p<0.01). LV ejection fraction was significantly lower in ESRD group (p<0.05). There were no significant differences in mitral inflow velocities (E, E/A, DT) between the two groups except A velocity, which was significantly higher in ESRD group (p<0.01). However, early diastolic mitral annular velocity (E') at rest (5.3+/-1.3 cm/sec vs. 6.5+/-1.5 cm/sec, p=0.013) and augmentation of E' with exercise (deltaE') were significantly lower in ESRD group compared with controls (at 25W exercise, 1.3+/-1.6 cm/sec vs. 4.0+/-3.0 cm/sec, p=0.002; at 50W exercise, 3.3+/-2.3 cm/sec vs. 6.5+/-5.3 cm/sec, p=0.030). CONCLUSION: Unlike conventional mitral inflow parameters, longitudinal resting diastolic function and diastolic functional reserve during exercise assessed by DTI were significantly reduced in ESRD patients starting dialysis treatment.
