Predictors of increased left ventricular filling pressure in dialysis patients with preserved left ventricular ejection fraction.
OBJECTIVE
To study the left and right ventricular function and to assess the predictors of increased left ventricular (LV) filling pressure in dialysis patients with preserved LV ejection fraction.


METHODS
This study included 63 consecutive patients (age 57+/-14 years, 57% women) with end-stage renal failure. Echocardiography, including tissue Doppler measurements, was performed in all patients. Based on the median value of the ratio of transmitral early diastolic velocity to early myocardial velocity (E/E' ratio), patients were divided into 2 groups: the group with high filling pressure (E/E'>10.16) and the group with low filling pressure (E/E'< or =10.16).


RESULTS
Compared with patients with low filling pressure, the group of patients with high filling pressure included a higher proportion of diabetic patients (41% vs 13%, P=0.022) and had greater LV mass index (211+/-77 vs 172+/-71 g/m3, P=0.04), lower LV lateral long axis amplitude (1.4+/-0.3 vs 1.6+/-0.3 cm, P=0.01), lower E wave (84+/-19 vs 64+/-18cm/s, P<0.001), higher systolic myocardial velocity (S': 8.6+/-1. 5 vs 7.0+/-1.3 cm/s, P<0.001), and lower diastolic myocardial velocities (E': 6.3+/-1.9 vs 9.5+/-2.9 cm/s, P<0.001; A': 8.4+/-1.9 vs 9.7+/-2.5 cm/s, P=0.018). Multivariate analysis identified LV systolic myocardial velocity - S' wave (adjusted odds ratio, 1.909; 95% confidence interval, 1.060-3.439; P=0.031) and age (1.053; 1.001-1.108; P=0.048) as the only independent predictors of high LV filling pressure in dialysis patients.


CONCLUSIONS
In dialysis patients with preserved left ventricular ejection fraction, reduced systolic myocardial velocity and elderly age are independent predictors of increased left ventricular filling pressure.
Bajraktari
Gani
G
Service of Cardiology, Clinic of Internal Medicine, University Clinical Centre of Kosova, Rrethi i Spitalit, p.n. 10000 Prishtina, Kosovo. ganibajraktari@yahoo.co.uk
Berbatovci-Ukimeraj
Mimoza
M
Hajdari
Ali
A
Ibraimi
Lavdim
L
Daullxhiu
Irfan
I
Elezi
Ymer
Y
Ndrepepa
Gjin
G
D000367:Age Factors; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*; D017725:Ventricular Pressure / Q000502:physiology*