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Diastolic distensibility, filling, or relaxation is abnormal, though left ventricular ejection fraction may remain normal or decline. In heart failure with preserved ejection fraction, symptomatic pulmonary congestion occurs despite systolic ejection fraction >50%. Surgical patients with grade III diastolic dysfunction show more major adverse cardiovascular events, and peri-operative haemodynamic instability and fluid overload may precipitate pulmonary oedema.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/left-ventricular-diastolic-dysfunction-in-chronic-kidney-disease-and-anaesthesia-implications-minireviews/406694/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/left-ventricular-diastolic-dysfunction-in-chronic-kidney-disease-and-anaesthesia-implications-minireviews/406694.png","ImageObject",300,407,{"name":92,"@type":93},"Franzy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"How is left ventricular diastolic dysfunction assessed in chronic kidney disease?","Question",{"text":113,"@type":114},"Echocardiography is used to determine whether diastolic dysfunction is present and to gauge its severity. Doppler methods and cardiac catheterization can also be used to ascertain diastolic dysfunction.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Why can patients have heart failure symptoms even when ejection fraction is preserved?",{"text":118,"@type":114},"In heart failure with preserved ejection fraction, patients develop symptomatic pulmonary congestion despite a systolic ejection fraction greater than 50%. This condition is commonly associated with ventricular diastolic dysfunction.",{"name":120,"@type":111,"acceptedAnswer":121},"What peri-operative risks are linked to severe (grade III) diastolic dysfunction in surgical patients?",{"text":122,"@type":114},"Surgical patients with grade III diastolic dysfunction have increased incidence of major adverse cardiovascular events. Peri-operatively, haemodynamic instability and fluid overload are known to generate pulmonary oedema.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},406694,1790664269,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336478945519,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","| W | J | N | World Journal of\u003Cbr>Nephrology |\n| --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Nephrol 2025 December 25; 14(4): 111297  \nDOI: 10.5527/wjn.v14.i4.111297 ISSN 2220-6124 (online)  \nMINIREVIEWS  \nLeft ventricular diastolic dysfunction in chronic kidney disease and anaesthesia implications  \nHemlata Kapoor, Dheeraj Kapoor  \nSpecialty type: Multidisciplinary sciences  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade B  \nNovelty: Grade B  \nCreativity or Innovation: Grade C  \nScientific Significance: Grade B  \nP-Reviewer: Zhao SR, PhD, United States  \nReceived: June 27, 2025  \nRevised: July 29, 2025  \nAccepted: October 28, 2025  \nPublished online: December 25, 2025  \nProcessing time: 179 Days and 15.4 Hours  \nHemlata Kapoor, Department of Anaesthesiology and Intensive Care, Kokilaben Dhirubhai Ambani Hospital, Mumbai 400053, Mahārāshtra, India  \nDheeraj Kapoor, Deopartment of Endocrinology, Kokilaben Dhirubhai Ambani Hopsital and Research Centre, Mumbai 400053, India  \nCo-first authors: Hemlata Kapoor and Dheeraj Kapoor.  \nCorresponding author: Hemlata Kapoor, MD, Consultant, Department of Anaesthesiology and Intensive Care, Kokilaben Dhirubhai Ambani Hospital, 4 Bungalows Andheri W, Mumbai 400053, Mahārāshtra, [India.](India. h_sarinkapoor@hotmail.co.uk)[ h_sarinkapoor@hotmail.co.uk](India. h_sarinkapoor@hotmail.co.uk)  \nAbstract  \nLeft ventricular diastolic dysfunction is frequently noticed in patients with chronic kidney disease. Echocardiography is used to determine the presence and severity of diastolic dysfunction. In left ventricular diastolic dysfunction the ventricular diastolic distensibility, filling or relaxation is abnormal; however, the left ventricular ejection fraction may be normal or decreased. In heart failure with preserved ejection fraction, the patients have symptomatic pulmonary congestion even though the systolic ejection fraction is more than 50% . This condition is commonly associated with ventricular diastolic dysfunction. Increased incidence of major adverse cardiovascular events has been reported in surgical patients having grade III diastolic dysfunction. Peri-operatively haemodynamic instability and fluid overload in this set of patients is known to generate pulmonary oedema.  \nKey Words: Chronic kidney disease; Diastolic dysfunction; Anaesthesia; Heart failure; 2-Dimensional echocardiography  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \nCore Tip: The extent of diastolic dysfunction in renal failure patients is increasingly gaining interest. Its implications on progress of chronic kidney disease and vice versa are known as cardiorenal syndrome. These patients present with heart failure inspite of adequate ejection fraction. These patients sometimes have pulmonary oedema during weaning of from ventilator. Various pharmcotherapeutic agents have been found useful in preserving contractility of heart.  \n WJN  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 25, 2025  Volume 14  Issue 4   \nKapoor H et al. Left ventricular dysfunction and CKD  \nCitation: Kapoor H, Kapoor D. Left ventricular diastolic dysfunction in chronic kidney disease and anaesthesia implications. World JNephrol 2025; 14(4): 111297  \nURL: [https://www.wjgnet.com/2220-6124/full/v14/i4/111297.htm](https://www.wjgnet.com/2220-6124/full/v14/i4/111297.htm)  \nDOI: [https://dx.doi.org/10.5527/wjn.v14.i4.111297](https://dx.doi.org/10.5527/wjn.v14.i4.111297)  \nINTRODUCTION  \nPatients with chronic kidney disease (CKD) often have cardiovascular disease which accounts for approximately 40% of the deaths in patients with CKD stage 4 and 5 [1] . Long standing hypertension, chronic fluid overload and uraemia in these patients lead to diffuse interstitial myocardial fibrosis, abnormal myocardial ","cbCaisylpRskmDAA","https://ap.wps.com/l/cbCaisylpRskmDAA","pdf",401723,"English","# Abstract\n## Introduction\n## Stages of ventricular diastole\n## Molecular mechanisms\n## Assessing diastolic dysfunction\n## Invasive and non-invasive measurements","[{\"question\":\"How is left ventricular diastolic dysfunction assessed in chronic kidney disease?\",\"answer\":\"Echocardiography is used to determine whether diastolic dysfunction is present and to gauge its severity. Doppler methods and cardiac catheterization can also be used to ascertain diastolic dysfunction.\"},{\"question\":\"Why can patients have heart failure symptoms even when ejection fraction is preserved?\",\"answer\":\"In heart failure with preserved ejection fraction, patients develop symptomatic pulmonary congestion despite a systolic ejection fraction greater than 50%. This condition is commonly associated with ventricular diastolic dysfunction.\"},{\"question\":\"What peri-operative risks are linked to severe (grade III) diastolic dysfunction in surgical patients?\",\"answer\":\"Surgical patients with grade III diastolic dysfunction have increased incidence of major adverse cardiovascular events. Peri-operatively, haemodynamic instability and fluid overload are known to generate pulmonary oedema.\"}]","Left ventricular diastolic dysfunction in chronic kidney disease and anaesthesia implications - MiniReviews | PDF",1790567360,18]