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Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction
Author(s) -
Wang Wei,
Wang Yueheng,
Chen Xiaoxue,
Yuan Lijun,
Bai Hui
Publication year - 2019
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14264
Subject(s) - ventricle , diastole , cardiology , medicine , ejection fraction , diastolic function , ventricular filling , heart failure , blood pressure
Background Intra‐ventricular blood flow dynamics is considered as an important component of left ventricular ( LV ) function assessment. The purpose of this study was to evaluate the LV diastolic function in chronic kidney disease ( CKD ) with different degrees of LV diastolic dysfunction ( LVDD ) by using flow energetic parameters. Methods In this study, a total of 96 cases were recruited, including 58 CKD patients and 38 healthy controls. CKD patients were divided into 2 groups according to LVDD severity, named as DD 1 and DD 2. Vector flow‐mapping ( VFM ) analysis was executed to calculate left ventricle average energy loss ( EL ) during early filling phase (E‐ EL _ave), atrial filling phase (A‐ EL _ave), diastole phase (D‐ EL _ave), and ejection phase (S‐ EL _ave). Moreover, the average vortex circulation during early filling phase (E‐cir_ave) and atrial filling phase (A‐cir_ave) was also assessed in the apical three‐chamber view. The rate of average EL during early filling and atrial filling was expressed as E/A‐ EL . Result Compared to the control group, A‐ EL _ave, S‐ EL _ave, and A‐cir_ave in the DD 1 group were higher ( P < 0.05), and all parameters were obviously higher in the DD 2 group ( P < 0.05). In the control group and the DD 2 subgroup, the E‐ EL _ave value was significantly higher than A‐ EL _ave value, which was opposite to the DD 1 group. As diastolic dysfunction worsened, E‐ EL _ave and D‐ EL _ave risen gradually ( P < 0.05), and A‐ EL _ave and S‐ EL _ave were slightly elevated with no significance. There were significant correlations between LV diastolic function and flow energetic parameters. Stepwise multiple regression analysis revealed that various LV function parameters could be regarded as independent predictors of average diastolic EL (all P < 0.01). Conclusions For CKD patient with LVDD and LVEF > 50%, effective LV filling and systolic ejection with optimized energy consumption have been impaired. As a new flow‐derived index, EL can quantitatively evaluate LV diastolic function in terms of blood fluid dynamics in CKD with various LVDD .