Elevated E/E' predicts cardiovascular events in hemodialysis patients with preserved systolic function

Abstract

Objective We conducted a cohort study to investigate whether diastolic function could predict cardiovascular (CV) events in 161 HD patients with preserved systolic function. Materials and Methods The ratio of early transmitral flow velocity to early mitral annular velocity (E/E') was measured by tissue Doppler imaging. Patients were stratified into two groups based on whether they experienced a CV event. Results During a 4-year follow-up period, 64 patients experienced a CV event. The E/E' values (15.18 ± 5.78) in the CV-event group were significantly higher than in the group who had not experienced a CV event (12.32 ± 4.23). Kaplan-Meier analysis indicated that the incidence of CV events was significantly higher in the group of patients whose E/E' was >15 than in the group whose E/E' was ≤15 (log-rank p=0.0016). Multivariate Cox proportional hazards regression analysis revealed the E/E' ratio to be a significant predictor of CV events in HD patients with preserved LV systolic function. Conclusion The results of this study showed that elevated E/E' ratio in chronic HD patients predicts CV events better than other echocardiographic parameters. © 2012 The Japanese Society of Internal Medicine.