Characteristics of a Subset of Patients With Reversible Systolic Dysfunction in Chronic Kidney Disease
Article first published online: 18 APR 2011
© 2011 Wiley Periodicals, Inc.
Congestive Heart Failure
Volume 17, Issue 3, pages 120–126, May/June 2011
How to Cite
Adhyapak, S. M. and Iyengar, S. S. (2011), Characteristics of a Subset of Patients With Reversible Systolic Dysfunction in Chronic Kidney Disease. Congestive Heart Failure, 17: 120–126. doi: 10.1111/j.1751-7133.2011.00214.x
- Issue published online: 25 MAY 2011
- Article first published online: 18 APR 2011
- Manuscript received October 21, 2010; revised December 20, 2010; accepted January 16, 2011
Congest Heart Fail. 2011;17:120–126. ©2011 Wiley Periodicals, Inc.
There exists a subgroup of uremic cardiomyopathy patients who experience resolution of heart failure symptoms with recovery of normal cardiac geometry following hemodialysis. The authors studied 52 patients with chronic kidney disease on hemodialysis over a period of 190 days. There were 29 patients with systolic dysfunction (left ventricular ejection fraction <40%). Twenty-three patients with preserved systolic function had diastolic dysfunction. Of the 29 patients with systolic dysfunction, 10 patients had significant improvement in New York Heart Association functional class and left ventricular internal diameter in diastole (LVIDd: 59.8±2.6–55.92 mm and left ventricular internal diameter in systole [LVIDs]: 51.8±1.8–34±1.2 mm; P<.001) with significant increases in left ventricular ejection fraction (30.55%–50.14%; P<.001). These patients had the highest baseline serum levels of troponin I ( P=.024), which decreased significantly with recovery of cardiac function. When the entire study group was regrouped as those below and those above the median change of C-reactive protein (CRP), patients with CRP greater than the median change had significant improvements in LVIDs and ejection fraction. A subgroup of patients with uremic cardiomyopathy who demonstrated reversible left ventricular systolic dysfunction had high levels of serum troponin I levels at presentation, which regressed with recovery of ventricular function in parallel with CRP levels.