Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW‐CKD Data
Background Few studies have examined the association between the early diastolic mitral inflow velocity/early diastolic mitral annulus velocity ratio (E/e’) and chronic kidney disease progression. Methods and Results We reviewed data from 2238 patients with nondialysis chronic kidney disease from th...
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| Format: | Article |
| Language: | English |
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Wiley
2022-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.025554 |
| _version_ | 1811167022208253952 |
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| author | Eunjeong Kang Sung Woo Lee Hyunjin Ryu Minjung Kang Seonmi Kim Sue K. Park Ji Yong Jung Kyu‐Beck Lee Seung Hyeok Han Curie Ahn Kook‐Hwan Oh |
| author_facet | Eunjeong Kang Sung Woo Lee Hyunjin Ryu Minjung Kang Seonmi Kim Sue K. Park Ji Yong Jung Kyu‐Beck Lee Seung Hyeok Han Curie Ahn Kook‐Hwan Oh |
| author_sort | Eunjeong Kang |
| collection | DOAJ |
| description | Background Few studies have examined the association between the early diastolic mitral inflow velocity/early diastolic mitral annulus velocity ratio (E/e’) and chronic kidney disease progression. Methods and Results We reviewed data from 2238 patients with nondialysis chronic kidney disease from the KNOW‐CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease); data from 163 patients were excluded because of missing content. A >50% decrease in estimated glomerular filtration rate from baseline, doubling of serum creatinine, or dialysis initiation and/or kidney transplantation were considered renal events. At baseline, median (interquartile range) ejection fraction and E/e’ were 64.0% (60.0%–68.0%) and 9.1 (7.4–11.9), respectively. Proportions of ejection fraction <50% and E/e’ ≥15 were 1.3% and 9.6%, respectively. More than one quarter of patients (27.2%) had an estimated glomerular filtration rate <30 mL/min per 1.73 m2. During the mean 59.1‐month follow‐up period, 724 patients (34.9%) experienced renal events. In multivariable Cox proportional hazard regression analysis, the hazard ratio with 95% CI per 1‐unit increase in E/e’ was 1.027 (1.005–1.050; P=0.016). Penalized spline curve analysis yielded a suggested threshold of E/e’ for renal events of 12; in our data set, the proportion of E/e’ ≥12 was 4.1%. Conclusions Increased E/e’ was associated with an increased hazard of renal events, suggesting that diastolic heart dysfunction is a novel risk factor for chronic kidney disease progression. |
| first_indexed | 2024-04-10T16:02:09Z |
| format | Article |
| id | doaj.art-085fd0d959354aedbf29b6cde5fa933c |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T16:02:09Z |
| publishDate | 2022-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-085fd0d959354aedbf29b6cde5fa933c2023-02-10T09:15:41ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-07-01111310.1161/JAHA.122.025554Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW‐CKD DataEunjeong Kang0Sung Woo Lee1Hyunjin Ryu2Minjung Kang3Seonmi Kim4Sue K. Park5Ji Yong Jung6Kyu‐Beck Lee7Seung Hyeok Han8Curie Ahn9Kook‐Hwan Oh10Department of Internal Medicine Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine Seoul South KoreaDepartment of Internal Medicine Uijeongbu Eulji University Medical Center, Uijeongbu‐si Gyeonggi‐do South KoreaDepartment of Internal Medicine Seoul National University College of Medicine Seoul South KoreaDepartment of Internal Medicine Seoul National University College of Medicine Seoul South KoreaDepartment of Internal Medicine Seoul National University College of Medicine Seoul South KoreaDepartment of Preventive Medicine Seoul National University College of Medicine Seoul South KoreaDepartment of Internal Medicine Gachon University Gil Medical Center, Gachon University College of Medicine Incheon South KoreaDepartment of Internal Medicine Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul South KoreaDepartment of Internal Medicine Institute of Kidney Disease Research, College of Medicine, Yonsei University Seoul South KoreaDepartment of Internal Medicine National Medical Center Seoul South KoreaDepartment of Internal Medicine Seoul National University College of Medicine Seoul South KoreaBackground Few studies have examined the association between the early diastolic mitral inflow velocity/early diastolic mitral annulus velocity ratio (E/e’) and chronic kidney disease progression. Methods and Results We reviewed data from 2238 patients with nondialysis chronic kidney disease from the KNOW‐CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease); data from 163 patients were excluded because of missing content. A >50% decrease in estimated glomerular filtration rate from baseline, doubling of serum creatinine, or dialysis initiation and/or kidney transplantation were considered renal events. At baseline, median (interquartile range) ejection fraction and E/e’ were 64.0% (60.0%–68.0%) and 9.1 (7.4–11.9), respectively. Proportions of ejection fraction <50% and E/e’ ≥15 were 1.3% and 9.6%, respectively. More than one quarter of patients (27.2%) had an estimated glomerular filtration rate <30 mL/min per 1.73 m2. During the mean 59.1‐month follow‐up period, 724 patients (34.9%) experienced renal events. In multivariable Cox proportional hazard regression analysis, the hazard ratio with 95% CI per 1‐unit increase in E/e’ was 1.027 (1.005–1.050; P=0.016). Penalized spline curve analysis yielded a suggested threshold of E/e’ for renal events of 12; in our data set, the proportion of E/e’ ≥12 was 4.1%. Conclusions Increased E/e’ was associated with an increased hazard of renal events, suggesting that diastolic heart dysfunction is a novel risk factor for chronic kidney disease progression.https://www.ahajournals.org/doi/10.1161/JAHA.122.025554cardiorenal syndromechronic kidney diseasediastolic heart dysfunctionearly predictorprogression |
| spellingShingle | Eunjeong Kang Sung Woo Lee Hyunjin Ryu Minjung Kang Seonmi Kim Sue K. Park Ji Yong Jung Kyu‐Beck Lee Seung Hyeok Han Curie Ahn Kook‐Hwan Oh Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW‐CKD Data Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiorenal syndrome chronic kidney disease diastolic heart dysfunction early predictor progression |
| title | Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW‐CKD Data |
| title_full | Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW‐CKD Data |
| title_fullStr | Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW‐CKD Data |
| title_full_unstemmed | Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW‐CKD Data |
| title_short | Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW‐CKD Data |
| title_sort | left ventricular diastolic dysfunction and progression of chronic kidney disease analysis of know ckd data |
| topic | cardiorenal syndrome chronic kidney disease diastolic heart dysfunction early predictor progression |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.025554 |
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