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Coronary microcirculation and left ventricular diastolic function: comparison between patients on hemodialysis and peritoneal dialysis

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Abstract

Background

End-stage renal disease is considered to influence coronary microcirculation and left ventricular (LV) diastolic function. We investigated whether differences exist in LV diastolic function indices and coronary flow reserve (CFR) between patients on hemodialysis (HD) and peritoneal dialysis (PD).

Methods

A complete transthoracic echocardiographic study was performed on 21 HD and 22 PD patients and LV diastolic function was evaluated. CFR was estimated using transthoracic Doppler echocardiography on the left anterior descending artery, during high-dose dypiridamole infusion.

Results

HD and PD groups did not differ regarding Doppler-derived diastolic indices, but they significantly differed in the frequency of severe LV hypertrophy (38.1% in HD vs 4.5% in PD group, p = 0.009) and grade II diastolic dysfunction (42.9% in HD vs 4.5% in PD group, p = 0.004). No patient had restrictive filling pattern. There was no difference in the prevalence of arterial hypertension and diabetes mellitus in patients with grade II vs less than grade II dysfunction. Mean CFR was similar in the HD and PD groups (2.25 ± 0.65 vs 2.36 ± 0.76, p = 0.635) and lower in patients with grade II diastolic dysfunction (1.87 ± 0.43 vs 2.44 ± 0.72, p = 0.023) and diabetes (1.70 ± 0.59 vs 2.39 ± 0.68, p = 0.04). LV mass index was negatively associated with CFR (r = − 0.308, p = 0.045).

Conclusion

Patients on HD had more advanced diastolic dysfunction compared to PD, independently of the presence of hypertension and diabetes. CFR did not differ between HD and PD patients, but it was significantly lower in diabetics and in patients with more advanced diastolic dysfunction.

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Funding

The authors received no financial support for the research, authorship, and publication of this article.

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Authors and Affiliations

  1. Second Department of Cardiology, University Hospital of Ioannina, Stavrou Niarchou Avenue, 45500, Ioannina, Greece

    Ioannis Gkirdis, Katerina K. Naka, Lampros Lakkas, Lampros K. Michalis & Christos S. Katsouras

  2. Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece

    Anila Duni, Rigas Kalaitzidis & Evangelia Dounousi

  3. Department of Nephrology, General Hospital of Ioannina “G. Hatzikosta”, Ioannina, Greece

    Panagiota Manolakaki & Konstantinos Koulousios

Authors
  1. Ioannis Gkirdis
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  2. Katerina K. Naka
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  3. Lampros Lakkas
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  4. Panagiota Manolakaki
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  10. Christos S. Katsouras
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Contributions

IG: study conception, data acquisition, data analysis, and manuscript preparation. KKN and ED: study conception and design, critical appraisal, and study supervision. LL: study design, data acquisition, and critical appraisal. PM, AD, KK, and RK: enrollment process, data acquisition, and critical appraisal. LKM: critical appraisal and study supervision. CSK: study conception, data analysis, manuscript preparation, and study supervision. All authors provided important intellectual content to this work.

Corresponding author

Correspondence to Ioannis Gkirdis.

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Conflict of interest

Ioannis Gkirdis, Katerina K. Naka, Lampros Lakkas, Panagiota Manolakaki, Anila Duni, Konstantinos Koulousios, Rigas Kalaitzidis, Evangelia Dounousi, Lampros K. Michalis, and Christos S. Katsouras declare that they have no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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Gkirdis, I., Naka, K.K., Lakkas, L. et al. Coronary microcirculation and left ventricular diastolic function: comparison between patients on hemodialysis and peritoneal dialysis. J Echocardiogr 19, 103–112 (2021). https://doi.org/10.1007/s12574-020-00493-7

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  • DOI: https://doi.org/10.1007/s12574-020-00493-7

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