Comparison of Left Ventricular Diastolic dysfunctions in Chronic Renal Failure(CRF) Patients and in Elderly Patients

ABSTRACT

BACKGROUND: We consider that heart failure in elderly and Chronic renal failure patients is closely related to LV diastolic dysfunction. To determine the association between LV diastolic functions and heart failure, we assessed LV diastolic functions in elderly patients with pulmonary congestion and in Chronic renal failure patients by using pulsed doppler echocardiography. METHODS: In order to assess LV diastolic function, we performed pulsed doppler echocardiography on elderly patients with pulmonary congestion and Chronic Renal Failure patients from Nov; 2000 to June; 2001. The following parameters were used as indices of LV diastolic function; Mitral E wave(E), Mitral A wave(A), F/A ratio, Deceleration time(DT), Isovolumic relaxation time(IVRT), Systolic pulmonary venous flow(PVs), Diastolic pulmonary venous flow(PVd), PVs/PVd ratio. RESULTS: In elderly patients groups with pulmonary congestion, there was significant decreased in E/A ratio compared with CRF patients(0.693+/-0.18 vs 0.905+/-0.116, p<0.01). There was significant increase in deceleration time and isovolumic relaxation time in elderly patients with pulmonary congestion compared with CRF patients(DT 255.83+/-54.41 vs 210.80+/-48.53 p<0.05, IVRT; 123.06+/-26.07 vs 98.75+/-15.12, p<0.01). Although there was no significant difference, increased PVs/PVd ratio was noted in both groups. CONCLUSIONS: The results shows that the impairments of LV diastolic function were noted in both groups. Especially F/A ratio was significant decreased elderly patient group with pulmonary congestion and DT, IVRT were significant increase in elderly patient group with pulmonary congestion. Therefore Left ventricular relaxation is progressively impaired in old age and impaired LV relaxation results in in LV diastolic dysfunction But LV hypertrophy in ESRD patients results in LV diastolic dysfunction.