Significant correlation between ratio of brachial pre-ejection period to ejection time and left ventricular ejection fraction and mass index in patients with chronic kidney disease

Abstract

Background. Patients with chronic kidney disease (CKD) are associated with increased cardiovascular morbidity and mortality. An increase in the ratio of pre-ejection period (PEP) to ejection time (ET) is correlated with an increase in left ventricular mass index (LVMI) and a decrease in left ventricular ejection fraction (LVEF). Brachial PEP (bPEP) and brachial ET (bET) can be automatically determined by an ankle-brachial index (ABI)-form device. The aims of this study were to assess whether bPEP/bET is a useful parameter in evaluation of LVMI and LVEF in patients with CKD and to evaluate the diagnostic value of bPEP/bET in the prediction of LVEF < 50%.Methods. We consecutively enrolled 234 CKD patients from our Outpatient Department of Internal Medicine. Both bPEP and bET were measured using an ABI-form device. Clinical and echocardiographic parameters were compared and analysed.Results. Multivariate analysis results show that bPEP/bET, systolic blood pressure, and body mass index were positively while albumin was negatively associated with LVMI. In addition, increased bPEP/bET, coronary artery disease, decreased albumin, and increased triglyceride were independent factors associated with decreased LVEF. The area under the curve for bPEP/bET in the prediction of LVEF < 50% was 0.859.Conclusions. Our findings show that bPEP/bET is an important determinant of LVMI and LVEF in CKD patients. It is also helpful in identification of CKD patients with LVEF < 50%. Screening CKD patients by means of bPEP/bET may help identify a high risk group of increased LVMI and decreased LVEF. © 2009 The Author.