• Croatian medical journal · Dec 2009

    Predictors of increased left ventricular filling pressure in dialysis patients with preserved left ventricular ejection fraction.

    • Gani Bajraktari, Mimoza Berbatovci-Ukimeraj, Ali Hajdari, Lavdim Ibraimi, Irfan Daullxhiu, Ymer Elezi, and Gjin Ndrepepa.
    • Service of Cardiology, Clinic of Internal Medicine, University Clinical Centre of Kosova, Rrethi i Spitalit, p.n. 10000 Prishtina, Kosovo. ganibajraktari@yahoo.co.uk
    • Croat. Med. J. 2009 Dec 1; 50 (6): 543-9.

    AimTo 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.MethodsThis 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'< or =10.16).ResultsCompared 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), higher 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.ConclusionsIn dialysis patients with preserved left ventricular ejection fraction, reduced systolic myocardial velocity and elderly age are independent predictors of increased left ventricular filling pressure.

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