title: Impact of mild to moderate renal dysfunction on left ventricular relaxation function and prognosis in ambulatory patients with nonischemic dilated cardiomyopathy.
abstract: The relationship between mild-to-moderate renal dysfunction and cardiac diastolic dysfunction and cardiac events in patients with nonischemic dilated cardiomyopathy (NDCM) has not been fully elucidated. The aim of this study was to investigate the relationship between renal and cardiac function, as well as clinical outcome in patients with NDCM.We measured plasma BNP and eGFR, and performed cardiac catheterization in 135 patients with NDCM. LV dP/dt(max)and T(1/2) were determined as indexes of LV contractility and isovolumic relaxation, respectively. During a mean follow-up of 4.8 years, we monitored all patients for the occurrence of cardiac events, which were defined as cardiac death (from worsening HF or sudden death) and unscheduled admission for decompensated HF. Patients were classified into 3 groups on the basis of eGFR (mL min(-1) 1.73 m(-2)): eGFR ≥ 90 (n = 23, group A), 60 ≤ eGFR < 90 (n = 70, group B), and 30 ≤ eGFR < 60 (n = 42, group C). Whereas LV dP/dt(max) did not significantly differ among the 3 groups, T(1/2) was significantly longer in groups B and C than in group A (P < 0.01). Event-free survival in group C was significantly lower than that in groups A and B (P = 0.014, log-rank test). These results suggest that even mild renal dysfunction is associated with LV isovolumic relaxation impairment. In addition, moderate impairment of renal function is independently associated with cardiac events in patients with NDCM.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Ohshima
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hirashiki
authors.forename: Xian Wu
authors.initials: XW
authors.lastname: Cheng
authors.forename: Mutsuharu
authors.initials: M
authors.lastname: Hayashi
authors.forename: Daiske
authors.initials: D
authors.lastname: Hayashi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Okumura
authors.forename: Masaki
authors.initials: M
authors.lastname: Sakakibara
authors.forename: Hidehito
authors.initials: H
authors.lastname: Funahashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Ohshima
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D018450:Disease Progression; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D010045:Outpatients; D011379:Prognosis; D051437:Renal Insufficiency / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult