Original scientific paper
Predictors of Increased Left Ventricular Filling Pressure in Dialysis Patients with Preserved Left Ventricular Ejection Fraction
Gani Bajraktari
; Service of Cardiology, Internal Medicine Clinic, University Clinical Centre of Kosovo, Prichtina, Kosovo
Mimoza Berbatovci Ukimeraj
; Service of Nephrology, Internal Medicine Clinic, University Clinic Centre of Kosovo, Prishtina, Kosovo
Ali Hajdari
; Medical Faculty, University of Prishtina, Kosovo
Lavdim Ibraimi
; Medical Faculty, University of Prishtina, Kosovo
Irfan Daullxhiu
; Service of Cardiology, Internal Medicine Clinic, University Clinical Centre of Kosovo, Prichtina, Kosovo
Ymer Elezi
; Service of Nephrology, Internal Medicine Clinic, University Clinic Centre of Kosovo, Prishtina, Kosovo
Gjin Ndrepepa
; Deutsches Herzzentrum, Technishe Universitat, Munich, Germany
Abstract
Aim To study the left and right ventricular function and to
assess the predictors of increased left ventricular (LV) filling
pressure in dialysis patients with preserved LV ejection
fraction.
Methods This study included 63 consecutive patients
(age 57 ± 14 years, 57% women) with end-stage renal failure.
Echocardiography, including tissue Doppler measurements,
was performed in all patients. Based on the median
value of the ratio of transmitral early diastolic velocity
to early myocardial velocity (E/E’ ratio), patients were divided
into 2 groups: the group with high filling pressure
(E/E’>10.16) and the group with low filling pressure (E/
E’≤10.16).
Results Compared with patients with low filling pressure,
the group of patients with high filling pressure included
a higher proportion of diabetic patients (41% vs
13%, P = 0.022) and had greater LV mass index (211 ± 77
vs 172 ± 71 g/m3, P = 0.04), lower LV lateral long axis amplitude
(1.4 ± 0.3 vs 1.6 ± 0.3 cm, P = 0.01), lower E wave
(84 ± 19 vs 64 ± 18cm/s, P < 0.001), lower systolic myocardial
velocity (S’: 8.6 ± 1. 5 vs 7.0 ± 1.3 cm/s, P < 0.001), and
lower diastolic myocardial velocities (E’: 6.3 ± 1.9 vs 9.5 ± 2.9
cm/s, P < 0.001; A’: 8.4 ± 1.9 vs 9.7 ± 2.5 cm/s, P = 0.018). Multivariate
analysis identified LV systolic myocardial velocity
– S’ wave (adjusted odds ratio, 1.909; 95% confidence interval,
1.060-3.439; P = 0.031) and age (1.053; 1.001-1.108;
P = 0.048) as the only independent predictors of high LV
filling pressure in dialysis patients.
Conclusions In dialysis patients with preserved left ventricular
ejection fraction, reduced systolic myocardial velocity
and elderly age are independent predictors of increased
left ventricular filling pressure.
Keywords
Arterial hypertension; Dialysis; Doppler echocardiography; Left ventricular systolic function
Hrčak ID:
47909
URI
Publication date:
15.12.2009.
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