Association between Inflammatory Markers, Left Ventricular Systo – Diastolic Dysfunction and Right Heart Involvement in CKD Patients

Background: Chronic kidney disease (CKD) is characterized by an increased mortality and morbidity due to cardiovascular involvement. Both left ventricular systolic and diastolic function are affected since CKD early stages. Pathophysiology of heart failure in CKD patients involves left ventricular hyperthophy, dilated cardiomiopathy, arrythmias and cardiac fi brosis together with widespread infl ammatory status accountable for early atheroembolic disease. Methods: We have enrolled 146 patients (96 males and 50 females aged 68 ± 9 years with mean dialytic age of 18 ± 0.4 months) on hemodialysis treatment and 120 patients ( 72 males and 48 females aged 57 ± 8 years) on stage III – V CKD. They underwent trans – thoracic ecocardiography and screened for infl ammatory markers (CRP, IL-6, TNF-). Results: Hemodialysis patients showed signifi cant correlations between IL – 6, CRP and TNF- blood levels and systo - diastolic dysfunction parameters such as E/E’ ratio. Therefore, they also showed strong and signifi cant correlation between IL-6, CRP levels and right ventricular dysfunction indexes, such as TAPSE (tricuspid annulus plane systolic excursion) and systolic pulmonary artery pressure (PAPs). On the other hand, CKD patients showed no correlations between infl ammatory asset and right heart dysfunction. Conclusions: Our data confi rm close correlation between systolic dysfunction and infl ammatory markers in CKD and hemodialysis patients. Therefore, our fi ndings underline close relationships between infl ammatory markers and right heart dysfunction parameters in hemodialysis patients such as TAPSE and PAPs refl ecting right heart involvement in the development of cardio – renal syndrome.