BACKGROUND: Abnormal left ventricular (LV) deformation is an independent predictor of poor cardiovascular outcome in end-stage renal disease. Studies in early-stage chronic kidney disease (CKD) have not been performed despite the known graded inverse relationship between glomerular filtration rate and adverse cardiovascular events. METHODS: Forty patients with CKD stage 2 or 3 and no history of cardiovascular disease or diabetes and 30 healthy controls underwent Doppler myocardial imaging for longitudinal deformation (strain/strain rate). RESULTS: There were no differences in LV ejection fraction or systolic tissue Doppler velocities between patients with CKD and controls. In CKD, mean global strain (-15% +/- 4% vs -17% +/- 3%, P <.01) and mean global strain rate were reduced compared with controls (-0.88 +/- 0.16 vs -1.06 +/- 0.31, P <.05). Peak systolic strain was reduced in the basal lateral (-13.9% +/- 0.9% vs -17.9% +/- 1.02%, P <.01), basal septal (-17.1% +/- 0.8% vs -19.4% +/- 0.77%, P <.05), and mid-septal (-16.4% +/- 0.78% vs -18.9% +/- 0.88%, P <.05) walls with more basal postsystolic shortening (P <.01). Peak systolic strain rate was reduced in the basal lateral, mid-lateral, and mid-septal segments (P <.05). CONCLUSION: Conventional measures of systolic function are preserved in early-stage CKD, but systolic deformation is abnormal, consistent with an adverse cardiovascular prognosis.
BACKGROUND:Abnormal left ventricular (LV) deformation is an independent predictor of poor cardiovascular outcome in end-stage renal disease. Studies in early-stage chronic kidney disease (CKD) have not been performed despite the known graded inverse relationship between glomerular filtration rate and adverse cardiovascular events. METHODS: Forty patients with CKD stage 2 or 3 and no history of cardiovascular disease or diabetes and 30 healthy controls underwent Doppler myocardial imaging for longitudinal deformation (strain/strain rate). RESULTS: There were no differences in LV ejection fraction or systolic tissue Doppler velocities between patients with CKD and controls. In CKD, mean global strain (-15% +/- 4% vs -17% +/- 3%, P <.01) and mean global strain rate were reduced compared with controls (-0.88 +/- 0.16 vs -1.06 +/- 0.31, P <.05). Peak systolic strain was reduced in the basal lateral (-13.9% +/- 0.9% vs -17.9% +/- 1.02%, P <.01), basal septal (-17.1% +/- 0.8% vs -19.4% +/- 0.77%, P <.05), and mid-septal (-16.4% +/- 0.78% vs -18.9% +/- 0.88%, P <.05) walls with more basal postsystolic shortening (P <.01). Peak systolic strain rate was reduced in the basal lateral, mid-lateral, and mid-septal segments (P <.05). CONCLUSION: Conventional measures of systolic function are preserved in early-stage CKD, but systolic deformation is abnormal, consistent with an adverse cardiovascular prognosis.
Authors: Fernando L Martin; Paul M McKie; Alessandro Cataliotti; S Jeson Sangaralingham; Josef Korinek; Brenda K Huntley; Elise A Oehler; Gerald E Harders; Tomoko Ichiki; Sarah Mangiafico; Karl A Nath; Margaret M Redfield; Horng H Chen; John C Burnett Journal: Am J Physiol Regul Integr Comp Physiol Date: 2011-11-09 Impact factor: 3.619
Authors: Rafael Kramann; Johanna Erpenbeck; Rebekka K Schneider; Anna B Röhl; Marc Hein; Vincent M Brandenburg; Merel van Diepen; Friedo Dekker; Nicolaus Marx; Jürgen Floege; Michael Becker; Georg Schlieper Journal: J Am Soc Nephrol Date: 2014-04-03 Impact factor: 10.121
Authors: Meyeon Park; Chi-yuan Hsu; Yongmei Li; Rakesh K Mishra; Martin Keane; Sylvia E Rosas; Daniel Dries; Dawei Xie; Jing Chen; Jiang He; Amanda Anderson; Alan S Go; Michael G Shlipak Journal: J Am Soc Nephrol Date: 2012-08-30 Impact factor: 10.121
Authors: Krista L Lentine; Huiling Xiao; Daniel C Brennan; Mark A Schnitzler; Todd C Villines; Kevin C Abbott; David Axelrod; Jon J Snyder; Paul J Hauptman Journal: Am Heart J Date: 2009-12 Impact factor: 4.749
Authors: Erin D Unger; Ruth F Dubin; Rajat Deo; Vistasp Daruwalla; Julie L Friedman; Crystal Medina; Lauren Beussink; Benjamin H Freed; Sanjiv J Shah Journal: Eur J Heart Fail Date: 2015-12-03 Impact factor: 15.534