Relation of proximal aorta stiffness to left ventricular diastolic function in patients with end-stage renal disease.
OBJECTIVE
We examined the relationship between proximal aortic stiffness and left ventricular (LV) diastolic function in patients with end-stage renal disease (ESRD).


METHODS
We studied 99 patients with ESRD with preserved LV ejection fraction greater than 50% and 83 controls. We assessed the aorta stiffness by measuring the pulse wave velocity (PWV) in the proximal aorta (PWVr) using a novel echo application and in the descending aorta (PWVcf) using a foot-to-foot method. Patients were classified according to LV diastolic filling pattern into normal, delayed relaxation, pseudonormal, and restrictive filing pattern groups.


RESULTS
Patients with ESRD had increased PWVr, PWVcf, and LV mass index (LVMI) compared with controls (all P < .0001). Patients with advanced diastolic dysfunction showed increased PWVr (P < .001) and PWVcf (P = .007) compared with those with mild diastolic dysfunction. PWVr was correlated to PWVcf (r = 0.74, P < .001) in patients with ESRD. Multivariate linear regression analysis revealed that PWVr was independently correlated to both LVMI and LV diastolic filling pattern.


CONCLUSIONS
Increased LVMI, advanced LV diastolic dysfunction, and generalized aortic stiffening were observed in patients with ESRD. Proximal aorta stiffness is associated with both increased LVMI and advanced LV diastolic dysfunction in those patients.
Patrianakos
Alexandros P
AP
Department of Cardiology, University Hospital of Heraklion, Crete, Greece. patrianakos@edu.med.uoc.gr
Parthenakis
Fragiskos I
FI
Karakitsos
Dimitrios
D
De Groot
Eric
E
Skalidis
Emmanuell A
EA
Nyktari
Eva
E
Daphnis
Eugene
E
Vardas
Panos E
PE
D001011:Aorta / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D015331:Cohort Studies; D003971:Diastole; D004548:Elasticity; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007676:Kidney Failure, Chronic / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology