title: The presence and impact of diastolic dysfunction on physical function and body composition in hemodialysis patients.
abstract: BACKGROUND
  Cardiovascular (CV) diseases are the main cause of death in maintenance hemodialysis (MHD) patients. Muscle wasting and physical function decline are common in MHD patients, and significantly impair their quality of life. These can result from abnormalities in cardiac function, which can be further worsened by physical deconditioning. Left ventricular diastolic function parameters were recently shown to be a better predictor of exercise capacity than systolic measures in patients with CV complications. But little is known about the relationship between cardiac function and physical function in MHD patients.
  
  
  METHODS
  In 82 MHD patients, left ventricular systolic dysfunction (LVSD) was assessed by ejection fraction and fractional shortening with echocardiography, and left ventricular diastolic dysfunction (LVDD) was assessed by pulse wave and tissue Doppler indices. Physical function was assessed by gait speed, performance on a shuttle walk test, and leg muscle strength. Dual-emission X-ray absorptiometry (DXA) was used to measure whole body lean mass (WBLM).
  
  
  RESULTS
  The prevalence of LVDD and LVSD was 48.8 and 12.2%, respectively. Gait speed, shuttle walk time, leg strength, and WBLM% were significantly higher in the group without LVDD than with LVDD (p < 0.05 for all). However, there was no significant difference in any measure of physical function or body composition between patients with and without LVSD.
  
  
  CONCLUSIONS
  These data suggest that LVDD is more closely related to physical function and body composition than LVSD in MHD patients, and hence that LVDD may be an important therapeutic target.
authors.affiliation: University of Illinois at Urbana-Champaign, Kinesiology and Community Health, Urbana, IL, USA. jinjeong@illinois.edu.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Jeong
authors.affiliation: School of Nursing, University of California, Los Angeles, Los-Angeles, CA, USA.
authors.forename: Pei-Tzu
authors.initials: PT
authors.lastname: Wu
authors.affiliation: University of Illinois at Urbana-Champaign, Kinesiology and Community Health, Urbana, IL, USA.
authors.forename: Brandon Michael
authors.initials: BM
authors.lastname: Kistler
authors.affiliation: Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
authors.forename: Peter John
authors.initials: PJ
authors.lastname: Fitschen
authors.affiliation: Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
authors.forename: Annabel Guzman
authors.initials: AG
authors.lastname: Biruete
authors.affiliation: University of Illinois at Chicago, Kinesiology, Nutrition, and Rehabilitation, Chicago, IL, USA.
authors.forename: Shane Aaron
authors.initials: SA
authors.lastname: Phillips
authors.affiliation: University of Illinois at Chicago, Kinesiology, Nutrition, and Rehabilitation, Chicago, IL, USA.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Ali
authors.affiliation: University of Illinois at Chicago, Kinesiology, Nutrition, and Rehabilitation, Chicago, IL, USA.
authors.forename: Bo
authors.initials: B
authors.lastname: Fernhall
authors.affiliation: University of Illinois at Urbana-Champaign, Kinesiology and Community Health, Urbana, IL, USA.
authors.forename: Kenneth Robert
authors.initials: KR
authors.lastname: Wilund
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001823:Body Composition; D003971:Diastole; D004452:Echocardiography; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D052097:Quadriceps Muscle / Q000503:physiopathology; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000628:therapy*; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016138:Walking / Q000502:physiology
keywords: Body composition; Cardiac abnormalities; Diastolic dysfunction; Maintenance hemodialysis patients; Physical function