title: Heart function disturbances in chronic kidney disease - echocardiographic indices.
abstract: BACKGROUND
  In chronic kidney disease (CKD) patients left ventricular (LV) diastolic dysfunction occurs frequently and is associated with heart failure (HF) and higher mortality. Left ventricular systolic dysfunction is associated with coronary artery disease (CAD) and is a major determinant of prognosis. The aim of this study was to assess indices of LV diastolic dysfunction in CKD patients.
  
  
  METHODS
  Study included 118 CKD patients. All patients underwent transthoracic echocardiography. Diastolic function based on E and A, E/A ratio and pulmonary vein flow velocities as well as EF%, deceleration time, RA, LA volume were assessed. In dialysis patients examination was carried out before and after dialysis.
  
  
  RESULTS
  In CKD patients the stage of renal failure was associated with the significant increase in LV mass (268.0 ±47.6 CKD I/II vs. 432.7 ±122.4 CKD V/dialysis, p < 0.0001), systolic LV (37.3 ±4.5 vs. 51.2 ±8.9, p < 0.0001) and diastolic LV (CKD I-II 44.7 ±4.1 vs. CKD III 48.5 ±6.7 vs. CKD IV 47.1 ±5.6; p = 0.004) dimensions and in the size of the LA (40.4 ±2.0 vs. 41.9 ±2.7 vs. 42.3 ±3.2 vs. 44.8 ±3.1; p < 0.0001). The increase the E/E' ratio between groups of patients (6.7 ±1.5 vs. 8.9 ±2.4 vs. 11.5 ±4.0 vs. 13.5 ±5.0; p < 0.0001) was seen in this study. The reduction in deceleration time (247.2 ±34.5 in CKD I/II vs. 197.4 ±61.0 in CKD IV, p = 0.0005) along with the decrease in estimated glomerular filtration rate was also observed in this study.
  
  
  CONCLUSIONS
  Early identification of factors involved is necessary to prevent this devastating process. Many indexes of contractility are used and each of them has imperfections. It seems that TVI, E, E/A and E/E' are good instruments for the early detection of left ventricular hypertrophy and diastolic dysfunction.
authors.affiliation: Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital of Lodz, Lodz, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Franczyk-Skóra
authors.affiliation: Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital of Lodz, Lodz, Poland ; Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Gluba
authors.affiliation: Department of Cardiology and Internal Medicine, Military Medical Institute of Warsaw, Warsaw, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Olszewski
authors.affiliation: Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland ; Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
authors.affiliation: Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital of Lodz, Lodz, Poland ; Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Rysz
keywords: chronic kidney disease; diastolic dysfunction; heart failure; indices