title: Differential association of proinflammatory cytokines with left ventricular diastolic dysfunction in subjects with and without continuous ambulatory peritoneal dialysis.
abstract: OBJECTIVE
  The association between inflammation and left ventricular (LV) diastolic dysfunction in continuous ambulatory peritoneal dialysis (CAPD) and non-CAPD patients is not established. The objective of this study was to test the above association and whether inflammation interacts with CAPD to increase LV diastolic dysfunction risks.
  
  
  RESULTS
  120 subjects with normal creatinine levels and 101 CAPD patients were recruited. Echocardiographic parameters were assessed in all patients. The participants were classified as having LV diastolic dysfunction by echocardiographic findings including mitral inflow E/A ratio < 1, deceleration time > 220 cm/s, or decreased peak annular early diastolic velocity in tissue Doppler imaging. Blood was sampled at the baseline for measurement of inflammation markers, including tissue necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). Subjects with LV diastolic dysfunction had higher proinflammation cytokines levels in both groups. Inflamed markers correlated significantly with echocardiography parameters for LV diastolic dysfunction in patients receiving CAPD. In a multivariate regression analysis adjusting for all the factors associated with LV diastolic dysfunction, inflammation is still significantly associated with left ventricular diastolic dysfunction (TNF-alpha, OR: 2.6, 95% CI: 2.0-3.35, p < 0.001; IL-6, OR: 1.26, 95% CI: 1.25-1.26, p = 0.01). In addition, the interaction of CAPD and inflammation significantly contributed to the development of LV diastolic dysfunction (CAPD∗ TNF-α: OR: 1.45, 95% CI: 1.13-1.79, P = 0.004).
  
  
  CONCLUSIONS
  We found inflammation plays a vital role for LV diastolic dysfunction especially in CAPD patients. A synergistic effect between CAPD and inflammation, especially TNF-α, would further aggravate LV diastolic dysfunction.
authors: Department of Laboratory Medicine, National Taiwan, University College of Medicine and Hospital, Taipei, Taiwan.
authors: J-K
authors: JK
authors: Lee
authors: H-H
authors: HH
authors: Lin
authors: C-T
authors: CT
authors: Tsai
authors: J-J
authors: JJ
authors: Chen
authors: C-C
authors: CC
authors: Kuo
authors: Y-C
authors: YC
authors: Lien
authors: J-W
authors: JW
authors: Lin
authors: J-W
authors: JW
authors: Huang
authors: S-W
authors: SW
authors: Hwang
authors: J-J
authors: JJ
authors: Hwang
authors: C-D
authors: CD
authors: Tseng
authors: F-T
authors: FT
authors: Chiang
authors: J-J
authors: JJ
authors: Chen
authors: C-K
authors: CK
authors: Wu