Diagnostics (Jun 2024)

The Association between Echocardiographic Parameters of Heart Failure with Preserved Ejection Fraction and Fluid Status Biomarkers in Hemodialysis Patients

  • Mariusz Lupa,
  • Agnieszka Pardała,
  • Anna Bednarek,
  • Jolanta Mrochem-Kwarciak,
  • Regina Deja,
  • Katarzyna Mizia-Stec,
  • Aureliusz Kolonko

DOI
https://doi.org/10.3390/diagnostics14121310
Journal volume & issue
Vol. 14, no. 12
p. 1310

Abstract

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Overhydration and cardiac function abnormalities are common in hemodialysis patients. The association of N-terminal prohormone for brain natriuretic peptide (NT-proBNP) and other fluid status biomarkers with echocardiographic parameters of heart failure with preserved ejection fraction (HFpEF) is scarcely investigated in this population. A total of 100 separate measurements performed in 50 dialysis patients (29 male, aged 60 ± 17 years) in NYHA class II/II and preserved left ventricle ejection fraction were analyzed. Plasma levels of NT-proBNP, mid-regional prohormone for atrial natriuretic peptide (MR-proANP) and copeptin (CPP) were measured. The E/e’ ratio as an index of HFpEF and other echocardiographic parameters were calculated. An E/e’ ratio >9 was associated with higher median right ventricular systolic pressure (RVSP) and LVMI values. Left atrium volume index (LAVI) as well as NT-proBNP and MR-proANP, but not CPP levels were significantly higher in this group. In a stepwise multivariate analysis, only CPP and IL-6 levels were found to be independently associated with the E/e’ ratio in the study group, whereas NT-proBNP and MR-proANP were associated only with left heart structure parameters and LVEF. Of the analyzed biomarkers, only the CPP level was found to be independently associated with the E/e’ ratio in maintenance hemodialysis patients.

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