Jin Hee Jeong1, Pei-Tzu Wu2, Brandon Michael Kistler3, Peter John Fitschen4, Annabel Guzman Biruete4, Shane Aaron Phillips5, Mohamed M Ali5, Bo Fernhall5, Kenneth Robert Wilund3. 1. University of Illinois at Urbana-Champaign, Kinesiology and Community Health, Urbana, IL, USA. jinjeong@illinois.edu. 2. School of Nursing, University of California, Los Angeles, Los-Angeles, CA, USA. 3. University of Illinois at Urbana-Champaign, Kinesiology and Community Health, Urbana, IL, USA. 4. Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA. 5. University of Illinois at Chicago, Kinesiology, Nutrition, and Rehabilitation, Chicago, IL, USA.
Abstract
BACKGROUND: Cardiovascular (CV) diseases are the main cause of death in maintenance hemodialysis (MHD) patients. Muscle wasting and physical function decline are common in MHD patients, and significantly impair their quality of life. These can result from abnormalities in cardiac function, which can be further worsened by physical deconditioning. Left ventricular diastolic function parameters were recently shown to be a better predictor of exercise capacity than systolic measures in patients with CV complications. But little is known about the relationship between cardiac function and physical function in MHD patients. METHODS: In 82 MHD patients, left ventricular systolic dysfunction (LVSD) was assessed by ejection fraction and fractional shortening with echocardiography, and left ventricular diastolic dysfunction (LVDD) was assessed by pulse wave and tissue Doppler indices. Physical function was assessed by gait speed, performance on a shuttle walk test, and leg muscle strength. Dual-emission X-ray absorptiometry (DXA) was used to measure whole body lean mass (WBLM). RESULTS: The prevalence of LVDD and LVSD was 48.8 and 12.2%, respectively. Gait speed, shuttle walk time, leg strength, and WBLM% were significantly higher in the group without LVDD than with LVDD (p < 0.05 for all). However, there was no significant difference in any measure of physical function or body composition between patients with and without LVSD. CONCLUSION: These data suggest that LVDD is more closely related to physical function and body composition than LVSD in MHD patients, and hence that LVDD may be an important therapeutic target.
BACKGROUND: Cardiovascular (CV) diseases are the main cause of death in maintenance hemodialysis (MHD) patients. Muscle wasting and physical function decline are common in MHD patients, and significantly impair their quality of life. These can result from abnormalities in cardiac function, which can be further worsened by physical deconditioning. Left ventricular diastolic function parameters were recently shown to be a better predictor of exercise capacity than systolic measures in patients with CV complications. But little is known about the relationship between cardiac function and physical function in MHD patients. METHODS: In 82 MHD patients, left ventricular systolic dysfunction (LVSD) was assessed by ejection fraction and fractional shortening with echocardiography, and left ventricular diastolic dysfunction (LVDD) was assessed by pulse wave and tissue Doppler indices. Physical function was assessed by gait speed, performance on a shuttle walk test, and leg muscle strength. Dual-emission X-ray absorptiometry (DXA) was used to measure whole body lean mass (WBLM). RESULTS: The prevalence of LVDD and LVSD was 48.8 and 12.2%, respectively. Gait speed, shuttle walk time, leg strength, and WBLM% were significantly higher in the group without LVDD than with LVDD (p < 0.05 for all). However, there was no significant difference in any measure of physical function or body composition between patients with and without LVSD. CONCLUSION: These data suggest that LVDD is more closely related to physical function and body composition than LVSD in MHD patients, and hence that LVDD may be an important therapeutic target.
Entities:
Keywords:
Body composition; Cardiac abnormalities; Diastolic dysfunction; Maintenance hemodialysis patients; Physical function
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