title: Stepwise increases in left ventricular mass index and decreases in left ventricular ejection fraction correspond with the stages of chronic kidney disease in diabetes patients.
abstract: OBJECTIVE
  Patients with diabetic nephropathy are reported to have a high prevalence of left ventricular structural and functional abnormalities. This study was designed to assess the determinants of left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF) in diabetic patients at various stages of chronic kidney disease (CKD).
  
  
  METHODS
  This cross-sectional study enrolled 285 diabetic patients with CKD stages 3 to 5 from our outpatient department of internal medicine. Clinical and echocardiographic parameters were compared and analyzed.
  
  
  RESULTS
  We found a significant stepwise increase in LVMI (P < 0.001), LVH (P < 0.001), and LVEF <55% (P = 0.013) and a stepwise decrease in LVEF (P = 0.038) corresponding to advance in CKD stages.
  
  
  CONCLUSIONS
  Our findings suggest that increases in LVMI and decreases in LVEF coincide with advances in CKD stages in patients with diabetes.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Szu-Chia
authors.initials: SC
authors.lastname: Chen
authors.forename: Jer-Ming
authors.initials: JM
authors.lastname: Chang
authors.forename: Wan-Chun
authors.initials: WC
authors.lastname: Liu
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Tsai
authors.forename: Jer-Chia
authors.initials: JC
authors.lastname: Tsai
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Shang-Jyh
authors.initials: SJ
authors.lastname: Hwang
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003928:Diabetic Nephropathies / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000473:pathology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology*