{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:49Z","timestamp":1787028649932,"version":"build-2736575974"},"reference-count":35,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T00:00:00Z","timestamp":1725753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dutch Heart Foundation","award":["2020B008"],"award-info":[{"award-number":["2020B008"]}]},{"name":"Dutch Heart Foundation","award":["2020T058"],"award-info":[{"award-number":["2020T058"]}]},{"name":"Dutch Heart Foundation","award":["101080430"],"award-info":[{"award-number":["101080430"]}]},{"name":"European Union\u2019s Horizon Research and Innovation Programme","award":["2020B008"],"award-info":[{"award-number":["2020B008"]}]},{"name":"European Union\u2019s Horizon Research and Innovation Programme","award":["2020T058"],"award-info":[{"award-number":["2020T058"]}]},{"name":"European Union\u2019s Horizon Research and Innovation Programme","award":["101080430"],"award-info":[{"award-number":["101080430"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Left ventricular diastolic dysfunction (LVDD) commonly coexists with kidney dysfunction. In this study, we investigated the presence of abnormalities in echocardiography parameters indicative of LVDD across stages of kidney function. Methods: We selected patients who visited a university hospital and had a serum creatinine and echocardiography reported in their medical records. Participants were categorized based on their kidney function: normal (estimated glomerular filtration rate [eGFR] \u2265 90 mL\/min\/1.73 m2), mildly decreased (eGFR: 60\u201390), moderately decreased (eGFR: 30\u201360), and severely decreased (eGFR &lt; 30). The relationship between kidney function and echocardiography parameters was examined using logistic and linear regressions. Results: Among 4022 patients (age: 66.5 years [SD: 12.1], 41% women), 26%, 50%, 20%, and 4% had a normal, mildly, moderately, and severely decreased kidney function, respectively. Compared to patients with normal kidney function, patients with mildly decreased kidney function had higher odds for an abnormal E\/e\u2032 ratio (OR: 1.51 [95% CI: 1.13, 2.02]). Patients with moderately decreased kidney function presented a higher risk of abnormal E\/e\u2032 (OR: 2.90 [95% CI: 2.08, 4.04]), LAVI (OR: 1.62 [95% CI: 1.13, 2.33]), TR velocity (OR: 2.31 [95% CI: 1.49, 3.57]), and LVMI (OR: 1.70 [95% CI: 1.31, 2.20]), while patients with severely decreased kidney function had higher odds for abnormal E\/e\u2032 (OR: 2.95 [95% CI: 1.68, 5.17]) and LVMI &gt; 95 g\/m2 in women or &gt;115 g\/m2 in men (OR: 2.07 [95% CI: 1.27, 3.38]). The linear regression showed a significant inverse association between eGFR and echocardiography parameters, meaning that with worse kidney function, the parameters for LVDD worsened as well. Conclusions: Abnormal echocardiography parameters of LVDD were present even in patients with mildly decreased kidney function. As the kidney function worsened, there was a gradual increase in the risk of abnormal parameters of LVDD.<\/jats:p>","DOI":"10.3390\/jcm13175313","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T05:06:06Z","timestamp":1725858366000},"page":"5313","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Left Ventricular Diastolic Dysfunction across Levels of Kidney Function: A Cross-Sectional Study Based on Routine Clinical Practice Data"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7692-9164","authenticated-orcid":false,"given":"Cindy P.","family":"Porras","sequence":"first","affiliation":[{"name":"Department of Nephrology and Hypertension, University Medical Center Utrecht, Room F03.204, Heidelberglaan 100, Postbus 85500, 3584CX Utrecht, The Netherlands"},{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, Postbus 85500, 3584CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8999-9946","authenticated-orcid":false,"given":"Elisa","family":"Dal Canto","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, Postbus 85500, 3584CX Utrecht, The Netherlands"},{"name":"Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Postbus 85500, Postbus 85500, 3508GA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Mar L.","family":"van Ommen","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Postbus 85500, Postbus 85500, 3508GA Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8942-7865","authenticated-orcid":false,"given":"M. Louis","family":"Handoko","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Center, De Boelelaan 1118, Postbus 7057, 1007MB Amsterdam, The Netherlands"},{"name":"Amsterdam Cardiovascular Sciences\/Heart Failure and Arrhythmias, Amsterdam University Medical Center, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands"},{"name":"Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"Haitjema","sequence":"additional","affiliation":[{"name":"Central Diagnostic Laboratory, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark C. H.","family":"de Groot","sequence":"additional","affiliation":[{"name":"Central Diagnostic Laboratory, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel L.","family":"Bots","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, Postbus 85500, 3584CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3276-6428","authenticated-orcid":false,"given":"Marianne C.","family":"Verhaar","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, University Medical Center Utrecht, Room F03.204, Heidelberglaan 100, Postbus 85500, 3584CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin W. M.","family":"Vernooij","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, University Medical Center Utrecht, Room F03.204, Heidelberglaan 100, Postbus 85500, 3584CX Utrecht, The Netherlands"},{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, Postbus 85500, 3584CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hill, N.R., Fatoba, S.T., Oke, J.L., Hirst, J.A., O\u2019Callaghan, C.A., Lasserson, D.S., and Hobbs, F.D.R. (2016). Global Prevalence of Chronic Kidney Disease\u2014A Systematic Review and Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0158765"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1136\/heartjnl-2020-318004","article-title":"Chronic kidney disease detection, staging and treatment in cardiovascular disease prevention","volume":"107","author":"Shlipak","year":"2021","journal-title":"Heart"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1161\/CIRCULATIONAHA.120.050686","article-title":"Cardiovascular Disease in Chronic Kidney Disease: Pathophysiological Insights and Therapeutic Options","volume":"143","author":"Jankowski","year":"2021","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1253\/circj.CJ-15-0064","article-title":"Diastolic dysfunction","volume":"79","author":"Jeong","year":"2015","journal-title":"Circ. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.mcna.2016.08.013","article-title":"Diastolic Dysfunction and Hypertension","volume":"101","author":"Nadruz","year":"2017","journal-title":"Med. Clin. N. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1093\/ndt\/gfad011","article-title":"Management of heart failure in patients with kidney disease\u2014Updates from the 2021 ESC guidelines","volume":"38","author":"Edwards","year":"2023","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s10741-023-10346-x","article-title":"Assessment and management of heart failure in patients with chronic kidney disease","volume":"29","author":"Guaricci","year":"2023","journal-title":"Heart Fail. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3904\/kjim.2013.28.1.35","article-title":"Tissue Doppler-derived E\/e\u2019 ratio as a parameter for assessing diastolic heart failure and as a predictor of mortality in patients with chronic kidney disease","volume":"28","author":"Kim","year":"2013","journal-title":"Korean J. Intern. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1476-7120-3-9","article-title":"Diastolic dysfunction and diastolic heart failure: Diagnostic, prognostic and therapeutic aspects","volume":"3","author":"Galderisi","year":"2005","journal-title":"Cardiovasc. Ultrasound"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1159\/000486938","article-title":"Clinical Impact of Left Ventricular Diastolic Dysfunction in Chronic Kidney Disease","volume":"195","author":"Ogawa","year":"2018","journal-title":"Contrib. Nephrol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Romejko, K., Rymarz, A., Szamotulska, K., Bartoszewicz, Z., Rozmyslowicz, T., and Niemczyk, S. (2022). Left Ventricular Diastolic Dysfunction in Chronic Kidney Disease Patients Not Treated with Dialysis. Nutrients, 14.","DOI":"10.3390\/nu14214664"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Kim, J.S., Yang, J.W., Yoo, J.S., Choi, S.O., and Han, B.G. (2017). Association between E\/e\u2019 ratio and fluid overload in patients with predialysis chronic kidney disease. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0184764"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.1093\/ndt\/gfu199","article-title":"The association between glomerular filtration rate and left ventricular function in two independent community-based cohorts of elderly","volume":"29","author":"Nerpin","year":"2014","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2358","DOI":"10.1038\/s41591-023-02526-x","article-title":"Semaglutide in HFpEF across obesity class and by body weight reduction: A prespecified analysis of the STEP-HFpEF trial","volume":"29","author":"Borlaug","year":"2023","journal-title":"Nat. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1007\/s10741-023-10324-3","article-title":"Efficacy and safety of sodium-glucose cotransporter-2 inhibitors in heart failure with mildly reduced or preserved ejection fraction: An overview of 36 systematic reviews","volume":"28","author":"Karakasis","year":"2023","journal-title":"Heart Fail. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.4103\/sja.SJA_543_18","article-title":"The STROBE guidelines","volume":"13","author":"Cuschieri","year":"2019","journal-title":"Saudi J. Anaesth."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e40516","DOI":"10.2196\/40516","article-title":"A Wolf in Sheep\u2019s Clothing: Reuse of Routinely Obtained Laboratory Data in Research","volume":"24","author":"Overmars","year":"2022","journal-title":"J. Med. Internet Res."},{"key":"ref_18","first-page":"13","article-title":"Linking laboratory and medication data: New opportunities for pharmacoepidemiological research","volume":"45","author":"Huisman","year":"2007","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New Creatinine- and Cystatin C\u2013Based Equations to Estimate GFR without Race","volume":"385","author":"Inker","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.echo.2016.01.011","article-title":"Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"29","author":"Nagueh","year":"2016","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3297","DOI":"10.1093\/eurheartj\/ehz641","article-title":"How to diagnose heart failure with preserved ejection fraction: The HFA-PEFF diagnostic algorithm: A consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)","volume":"40","author":"Pieske","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e025554","DOI":"10.1161\/JAHA.122.025554","article-title":"Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW-CKD Data","volume":"11","author":"Kang","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s12947-020-00228-9","article-title":"Diastolic function and its association with diabetes, hypertension and age in an outpatient population with normal stress echocardiography findings","volume":"18","author":"Sundqvist","year":"2020","journal-title":"Cardiovasc. Ultrasound"},{"key":"ref_24","unstructured":"(2020). RStudio: Integrated Development for R, RStudio, PBC. Available online: http:\/\/www.rstudio.com\/."},{"key":"ref_25","first-page":"1","article-title":"mice: Multivariate Imputation by Chained Equations in R","volume":"45","year":"2011","journal-title":"J. Stat. Softw."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"22","DOI":"10.3904\/kjim.2013.28.1.22","article-title":"Diastolic dysfunction and chronic kidney disease","volume":"28","author":"Cho","year":"2013","journal-title":"Korean J. Intern. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1089\/ars.2020.8184","article-title":"Inflammation and Oxidative Stress in Chronic Kidney Disease and Dialysis Patients","volume":"35","author":"Ebert","year":"2021","journal-title":"Antioxid. Redox Signal."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1002\/ehf2.12143","article-title":"The renal-cardiac connection in subjects with preserved ejection fraction: A population based study","volume":"4","author":"Jain","year":"2017","journal-title":"ESC Heart Fail."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Fitzpatrick, J.K., Parikh, R.V., Hamilton, S.A., Ambrosy, A.P., Tan, T.C., Bansal, N., and Go, A.S. (2023). The association between changes in echocardiography and risk of heart failure hospitalizations and death in adults with chronic kidney disease. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-35440-w"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1093\/ndt\/gfi075","article-title":"Left ventricular function in patients with chronic kidney disease evaluated by colour tissue Doppler velocity imaging","volume":"21","author":"Hayashi","year":"2006","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/ehf2.14511","article-title":"Association of mild kidney dysfunction with diastolic dysfunction and heart failure with preserved ejection fraction","volume":"11","author":"Vernooij","year":"2024","journal-title":"ESC Heart Fail."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Nguyen, H.T.T., Do, C.V., Dang, D.T.V., Do, L.D., Doan, L.H., and Dang, H.T.V. (2023). Progressive alterations of left atrial and ventricular volume and strain across chronic kidney disease stages: A speckle tracking echocardiography study. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1197427"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"73","DOI":"10.5662\/wjm.v7.i3.73","article-title":"Establishing the presence or absence of chronic kidney disease: Uses and limitations of formulas estimating the glomerular filtration rate","volume":"7","author":"Alaini","year":"2017","journal-title":"World J. Methodol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Han, B.G., Seol, J.H., Choi, S., Shin, D., Kim, J.S., and Kim, Y.H. (2023). Comparing Left Ventricular Diastolic Function between Peritoneal Dialysis and Non-Dialysis Patients with Stage 5 Chronic Kidney Disease: A Propensity Score-Matched Analysis. J. Clin. Med., 12.","DOI":"10.3390\/jcm12155092"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Suh, S.H., Oh, T.R., Choi, H.S., Kim, C.S., Bae, E.H., Oh, K.-H., Choi, K.H., Oh, Y.K., Ma, S.K., and Kim, S.W. (2022). Association of Left Ventricular Diastolic Dysfunction With Cardiovascular Outcomes in Patients With Pre-dialysis Chronic Kidney Disease: Findings From KNOW-CKD Study. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.844312"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/17\/5313\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:51:26Z","timestamp":1760111486000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/17\/5313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,8]]},"references-count":35,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["jcm13175313"],"URL":"https:\/\/doi.org\/10.3390\/jcm13175313","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,8]]}}}