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Relationships between kidney dysfunction and left ventricular diastolic dysfunction: a hospital-based retrospective study

Journal of Nephrology volume 34, pages 773–780 (2021)Cite this article

Abstract

Background

Preclinical left ventricular diastolic dysfunction (LVDD) is a high-risk state for heart failure. Kidney dysfunction is a known risk factor for heart failure, but its association with asymptomatic LVDD is not well-known.

Methods

A hospital-based retrospective cohort study was conducted on patients who underwent echocardiogram between 2006 and 2016 to assess the association between baseline kidney function and LVDD on echocardiogram. E/e′ ratio was defined as the ratio of peak velocity of early diastolic left ventricular inflow (E) to mitral annular velocity (e′). The primary outcome was time to development of LVDD, which was defined as E/e′ ratio > 14. The changes in the E/e′ ratio and other echocardiographic parameters were assessed using a mixed effects model.

Results

Among 1167 patients, the mean age was 61 years, and the mean baseline E/e′ ratio and ejection fraction were 9.6 and 69%, respectively. During a median follow-up of 3.2 years, 231 (19.8%) people developed LVDD. According to eGFR (mL/min/1.73 m2), the risk for LVDD based on hazard ratio [95% confidence interval (95% CI)] was 1.20 (0.82, 1.75) for 60 to < 90, 1.42 (0.87, 2.31) for 45 to < 60, and 2.57 (1.61, 4.09) for < 45 (P trend < 0.001). The adjusted risks (95% CI) for annual change in E/e′ ratio was 0.09 (0.03, 0.14) overall and 0.28 (0.11, 0.45) in the lowest eGFR group; the trend in changes in annual E/e′ ratio by baseline eGFR was significant (P trend = 0.01).

Conclusions

Relatively low kidney function was related with the risks for LVDD. Long-term cohort studies are warranted to confirm the association between LVDD and symptomatic heart failure in patients with kidney dysfunction.

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Fig. 1

Availability of data and material (data transparency)

The datasets used and/ or analyzed in the current study are available from the corresponding author with the permission of the ethics committee upon reasonable request.

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Acknowledgements

We deeply appreciate all the study participants and hospital staff for their participation and cooperation.

Funding

Not applicable.

Author information

Affiliations

  1. Department of Nephrology and Laboratory Medicine, Kanazawa University, Kanazawa, Japan

    Yoshiyasu Miyajima, Tadashi Toyama, Yusuke Nakade, Koichi Sato, Yuta Yamamura, Hisayuki Ogura, Shiori Yoneda-Nakagawa, Megumi Oshima, Taro Miyagawa, Shinji Kitajima, Akinori Hara, Yasunori Iwata, Norihiko Sakai, Miho Shimizu, Yoshio Sakai & Takashi Wada

  2. Department of Clinical Laboratory, Kanazawa University Hospital, Kanazawa, Japan

    Yoshiyasu Miyajima, Mika Mori, Yusuke Nakade, Soichiro Usui, Hiroyasu Oe, Yoshio Sakai & Takashi Wada

  3. Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan

    Tadashi Toyama & Hisayuki Ogura

  4. Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan

    Mika Mori & Soichiro Usui

  5. Department of Nephrology, Kanazawa Medical University School of Medicine, Uchinada, Japan

    Kengo Furuichi

Authors
  1. Yoshiyasu Miyajima
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  2. Tadashi Toyama
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  3. Mika Mori
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  4. Yusuke Nakade
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  5. Koichi Sato
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  6. Yuta Yamamura
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  7. Hisayuki Ogura
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  8. Shiori Yoneda-Nakagawa
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  9. Megumi Oshima
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  10. Taro Miyagawa
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  11. Soichiro Usui
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  12. Hiroyasu Oe
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  13. Shinji Kitajima
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  14. Akinori Hara
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  15. Yasunori Iwata
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  16. Norihiko Sakai
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  17. Miho Shimizu
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  18. Yoshio Sakai
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  19. Kengo Furuichi
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  20. Takashi Wada
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Contributions

TW and TT conceived the study. YM acquired the data. YM and TT performed the analyses and drafted the manuscript. All authors contributed to the interpretation of the results and approved the final version of the manuscript.

Corresponding authors

Correspondence to Tadashi Toyama or Takashi Wada.

Ethics declarations

Conflict of interest

None.

Ethics approval

The study protocol was approved by the ethics committee of Kanazawa University (approval number 907). The study was carried out in accordance with the principles of the Declaration of Helsinki.

Consent to participate

The study was announced on the hospital’s website. All participants were given the opportunity to opt out of the study by sending an opt-out document to the hospital if they wished. All analyses were performed using deidentified data.

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Not applicable.

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Cite this article

Miyajima, Y., Toyama, T., Mori, M. et al. Relationships between kidney dysfunction and left ventricular diastolic dysfunction: a hospital-based retrospective study. J Nephrol 34, 773–780 (2021). https://doi.org/10.1007/s40620-020-00940-9

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  • DOI: https://doi.org/10.1007/s40620-020-00940-9

Keywords

  • Renal insufficiency
  • Diastolic heart failure
  • Echocardiography
  • Retrospective studies