Investigation Of Cardiac Function And Influencing Factors Of Left Ventricular Diastolic Dysfunction In Patients On Maintenance Peritoneal Dialysis

Objective:To investigate the current status of cardiac function and left ventricular diastolic function in patients on maintenance peritoneal dialysis,and to find out the influencing factors of left ventricular diastolic dysfunction,so as to provide a basis for the diagnosis,treatment and prevention of clinical diseases.Methods:Demographic characteristics,clinical and laboratory indicators of patients were collected.Measured by color doppler ultrasound in patients with left ventricular diastolic diameter,interventricular septal thickness,left ventricular posterior wall thickness,left ventricular ejection fraction,left ventricular filling the maximum velocity of early mitral flow(E)and the maximum velocity of late mitral valve flow(A).Tissue doppler ultrasonography was used to determine the mitral root ring systolic peak velocity(Ea)and the early peak diastolic velocity of mitral root ring(Aa)of the mitral valve root ring.Left ventricular mass index(LVMI)was calculated according to Devereux correction formula.Left ventricular hypertrophy was defined as LVMI>125g/m~2 in men and>120g/m~2 in women.Left ventricular systolic dysfunction was defined as left ventricular ejection fraction<50%.Left ventricular diastolic dysfunction was defined as E/A<1 or Ea<Aa.Classification of left ventricular dysfunction:grade I E/A≤0.8,grade II 0.8<E/A≤2,grade III E/A>2.Among the 130 maintenance peritoneal dialysis patients,123 patients were diagnosed with left ventricular diastolic dysfunction,all of which were grade I and II diastolic dysfunction.No grade III diastolic dysfunction was found in this study.The 123 maintenance peritoneal dialysis patients were divided into grade I and grade II diastolic dysfunction according to the results of color Doppler ultrasound.The two groups were compared in demographic characteristics,clinical and laboratory indicators,and analyze the risk factors of left ventricular diastolic dysfunction.Results:The prevalence of left ventricular diastolic dysfunction was 94.6%in the study.And the prevalence of grade II diastolic dysfunction was 35.4%.Body mass index(BMI)(t=-2.058,P=0.042),blood phosphorus(t=-2.699,P=0.008)and brain natriuretic peptide(BNP)(t=-2.588,P=0.011)of grade II diastolic dysfunction were significantly different with grade I.Logistic regression analysis found that high BMI(OR=1.316,95%CI:1.117~1.550,P=0.001),high total cholesterol(OR=2.034,95%CI:1.153~3.588,P=0.014),high phosphorus(OR=3.855,95%CI:1.477~10.059,P=0.006)and high BNP(OR=1.003,95%CI:1.001~1.004,P=0.003)were risk factors of left ventricular diastolic dysfunction.In addition,the prevalence of left ventricular hypertrophy reached 39.8%in this study,and there was no significant correlation between left ventricular hypertrophy and left ventricular diastolic dysfunction(OR=1.000,95%CI:0.992~1.008,P=0.991).Conclusions:Most of maintenance peritoneal dialysis patients had left ventricular diastolic dysfunction.High BMI,high total cholesterol,high phosphorus and high BNP were risk factors of left ventricular diastolic function.