Association with Left Ventricular Diastolic Function Parameters and Right Brachial-ankle Pulse Wave Velocity in Hemodialysis Patients / 대한신장학회지

ABSTRACT

PURPOSE: Arterial stiffness is a major independent risk factor for cardiovascular morbidity and mortality in hemodialysis patients. It is hypothesized that arterial stiffness factor is attributable to the structural and functional changes of left ventricle (LV) caused by increased cardiac workload. So we investigated the relationship between brachial-ankle pulse wave velocity (baPWV) and diastolic dysfunction of left ventricle using echoardiographic transmitral blood flow pattern. METHODS: For 96 subjects (48 control patients, 48 hemodialysis patients), baPWV and echocardiographic indices for diastolic function, i.e. transmitral E, A, E/A, DT, IVRT were measured just before hemodialysis session. Role of baPWV was tested in a multiple regression model including age, gender, body mass index, predialysis blood pressure, heart rate, LV mass index and interdialysis weight gain. RESULTS: In the control group, LV mass index (beta=-0.350) and rbaPWV (beta=-0.403) had an independently correlation with E/A ratio. Rt-baPWV was independently correlated with DT (beta=-0.410) and IVRT (beta=0.500). In the hemodialysis group, systolic blood pressure (beta=-0.389) and heart rate (beta=-0.403) were the factors of E/A ratio. Rt-baPWV (beta=-0.557) was the factor determining E/A ratio only in female hemodialysis patients. CONCLUSION: PWV is independently correlated with E/A ratio only in female hemodialysis patients. Their relationship is limited or weak compared to normal control group.