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Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis: A Forgotten Risk Factor

Left ventricular diastolic dysfunction (LVDD) is common among patients undergoing peritoneal dialysis (PD). We examined the relationship between LVDD, major adverse cardiovascular events (MACE), and mortality in PD patients. A total of 149 patients undergoing PD with preserved left ventricular systo...

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Autores principales: Wu, Cho-Kai, Lee, Jen-Kuang, Wu, Yi-Fan, Tsai, Chia-Ti, Chiang, Fu-Tien, Hwang, Juey-Jen, Lin, Jiunn-Lee, Hung, Kuan-Yu, Huang, Jenq-Wen, Lin, Jou-Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602859/
https://www.ncbi.nlm.nih.gov/pubmed/25997054
http://dx.doi.org/10.1097/MD.0000000000000819
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author Wu, Cho-Kai
Lee, Jen-Kuang
Wu, Yi-Fan
Tsai, Chia-Ti
Chiang, Fu-Tien
Hwang, Juey-Jen
Lin, Jiunn-Lee
Hung, Kuan-Yu
Huang, Jenq-Wen
Lin, Jou-Wei
author_facet Wu, Cho-Kai
Lee, Jen-Kuang
Wu, Yi-Fan
Tsai, Chia-Ti
Chiang, Fu-Tien
Hwang, Juey-Jen
Lin, Jiunn-Lee
Hung, Kuan-Yu
Huang, Jenq-Wen
Lin, Jou-Wei
author_sort Wu, Cho-Kai
collection PubMed
description Left ventricular diastolic dysfunction (LVDD) is common among patients undergoing peritoneal dialysis (PD). We examined the relationship between LVDD, major adverse cardiovascular events (MACE), and mortality in PD patients. A total of 149 patients undergoing PD with preserved left ventricular systolic function were included and followed for 3.5 years. LVDD was diagnosed (according to the European Society of Cardiology guidelines) by conventional and tissue Doppler echocardiography. Serum high-sensitivity C-reactive protein (hsCRP) was measured. The location and volume of adipose tissue were assessed by computed tomography (CT) at the level of the fourth lumbar vertebra. Subjects with LVDD had higher levels of hsCRP, and more visceral and peritoneal fat than controls. The relationship between adjusted visceral adipose tissue and LVDD became nonsignificant when hsCRP and baseline demographic data were introduced into the logistic regression model (odds ratio = 1.52, P = 0.07). Subsequent hierarchical multivariate Cox regression analysis showed that LVDD was one of the most powerful determinants of MACE and mortality after adjusting for all confounding factors (hazard ratio [HR]: 1.71, 95% confidence interval [CI]: 1.43–3.51, P = 0.02 and HR: 2.25, 95% CI: 1.45–2.91, P = 0.04, respectively). Systemic inflammation (hsCRP) was also significantly associated with MACE and mortality (HR: 2.03, P = 0.03 and HR: 2.16, P = 0.04, respectively). LVDD is associated with systemic inflammation and increased visceral fat in patients undergoing PD. LVDD is also a sensitive, independent indicator of future MACE and mortality in PD patients.
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spelling pubmed-46028592015-10-27 Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis: A Forgotten Risk Factor Wu, Cho-Kai Lee, Jen-Kuang Wu, Yi-Fan Tsai, Chia-Ti Chiang, Fu-Tien Hwang, Juey-Jen Lin, Jiunn-Lee Hung, Kuan-Yu Huang, Jenq-Wen Lin, Jou-Wei Medicine (Baltimore) 5200 Left ventricular diastolic dysfunction (LVDD) is common among patients undergoing peritoneal dialysis (PD). We examined the relationship between LVDD, major adverse cardiovascular events (MACE), and mortality in PD patients. A total of 149 patients undergoing PD with preserved left ventricular systolic function were included and followed for 3.5 years. LVDD was diagnosed (according to the European Society of Cardiology guidelines) by conventional and tissue Doppler echocardiography. Serum high-sensitivity C-reactive protein (hsCRP) was measured. The location and volume of adipose tissue were assessed by computed tomography (CT) at the level of the fourth lumbar vertebra. Subjects with LVDD had higher levels of hsCRP, and more visceral and peritoneal fat than controls. The relationship between adjusted visceral adipose tissue and LVDD became nonsignificant when hsCRP and baseline demographic data were introduced into the logistic regression model (odds ratio = 1.52, P = 0.07). Subsequent hierarchical multivariate Cox regression analysis showed that LVDD was one of the most powerful determinants of MACE and mortality after adjusting for all confounding factors (hazard ratio [HR]: 1.71, 95% confidence interval [CI]: 1.43–3.51, P = 0.02 and HR: 2.25, 95% CI: 1.45–2.91, P = 0.04, respectively). Systemic inflammation (hsCRP) was also significantly associated with MACE and mortality (HR: 2.03, P = 0.03 and HR: 2.16, P = 0.04, respectively). LVDD is associated with systemic inflammation and increased visceral fat in patients undergoing PD. LVDD is also a sensitive, independent indicator of future MACE and mortality in PD patients. Wolters Kluwer Health 2015-05-22 /pmc/articles/PMC4602859/ /pubmed/25997054 http://dx.doi.org/10.1097/MD.0000000000000819 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0
spellingShingle 5200
Wu, Cho-Kai
Lee, Jen-Kuang
Wu, Yi-Fan
Tsai, Chia-Ti
Chiang, Fu-Tien
Hwang, Juey-Jen
Lin, Jiunn-Lee
Hung, Kuan-Yu
Huang, Jenq-Wen
Lin, Jou-Wei
Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis: A Forgotten Risk Factor
title Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis: A Forgotten Risk Factor
title_full Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis: A Forgotten Risk Factor
title_fullStr Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis: A Forgotten Risk Factor
title_full_unstemmed Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis: A Forgotten Risk Factor
title_short Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis: A Forgotten Risk Factor
title_sort left ventricular diastolic dysfunction in peritoneal dialysis: a forgotten risk factor
topic 5200
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602859/
https://www.ncbi.nlm.nih.gov/pubmed/25997054
http://dx.doi.org/10.1097/MD.0000000000000819
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