Stepwise increases in left ventricular mass index and decreases in left ventricular ejection fraction correspond with the stages of chronic kidney disease in diabetes patients

Abstract

Aims: Patients with diabetic nephropathy are reported to have a high prevalence of left ventricular structural and functional abnormalities. This study was designed to assess the determinants of left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF) in diabetic patients at various stages of chronic kidney disease (CKD).

Methods: This cross-sectional study enrolled 285 diabetic patients with CKD stages 3 to 5 from our outpatient department of internal medicine. Clinical and echocardiographic parameters were compared and analyzed.

Results: We found a significant stepwise increase in LVMI (P < 0.001), LVH (P < 0.001), and LVEF <55% (P = 0.013) and a stepwise decrease in LVEF (P = 0.038) corresponding to advance in CKD stages.

Conclusions: Our findings suggest that increases in LVMI and decreases in LVEF coincide with advances in CKD stages in patients with diabetes.

Figure 1

There was a significant trend for a stepwise increase in left ventricular mass index (LVMI) (P < 0.001 for trend) (a) and the prevalence of left ventricular hypertrophy (LVH) (44.4%, 61.6%, and 83.9%, resp.; P < 0.001 for trend) (b) corresponding to the advancement in chronic kidney disease from stage 3 to 5.

Figure 2

There was a significant trend for a stepwise decrease in left ventricular ejection fraction (LVEF) (P = 0.038 for trend) (a) and stepwise increase in the prevalence of LVEF < 55% (4.0%, 11.1%, and 17.2%, resp.; P < 0.013 for trend) (b) corresponding to the advancement in chronic kidney disease from stage 3 to 5.