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International Journal of Nephrology
Volume 2012 (2012), Article ID 963504, 7 pages
http://dx.doi.org/10.1155/2012/963504
Clinical Study

Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and Determinants

1Department of Cardiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
2Department of Nephrology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
3Department of Nephrology, Medisch Centrum Haagland, 2125 VA, The Hague, The Netherlands
4Department of Nephrology, Rijnland Ziekenhuis, Leiderdorp, The Netherlands

Received 8 January 2012; Accepted 23 February 2012

Academic Editor: Alessandro Amore

Copyright © 2012 Mihály K. de Bie et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Diastolic dysfunction is common among dialysis patients and is associated with increased morbidity and mortality. Novel echocardiographic speckle tracking strain analysis permits accurate assessment of left ventricular diastolic function, independent of loading conditions and taking all myocardial segments into account. The aim of the study was to evaluate the prevalence of diastolic dysfunction in chronic dialysis patients using this novel technique, and to identify its determinants among clinical and echocardiographic variables. Methods. Patients currently enrolled in the ICD2 study protocol were included for this analysis. Next to conventional echo measurements diastolic function was also assessed by global diastolic strain rate during isovolumic relaxation (SRIVR). Results. A total of 77 patients were included (age years, 74% male). When defined as E/SRIVR , the prevalence of diastolic dysfunction was higher compared to more conventional measurements (48% versus 39%). Left ventricular mass (OR 1.02, 95% CI 1.00–1.04, ) and pulse wave velocity (OR 1.34, 95% CI 1.07–1.68, ) were independent determinants of diastolic dysfunction. Conclusion. Diastolic dysfunction is highly prevalent among dialysis patients and might be underestimated using conventional measurements. Left ventricular mass and pulse wave velocity were the only determinants of diastolic dysfunction in these patients.