Nikki J Schoenmaker1, Irene M Kuipers2, Johanna H van der Lee3, Wilma F Tromp1, Maria van Dyck4, Marc Gewillig5, Nico A Blom2, Jaap W Groothoff1. 1. 1 Department of Paediatric Nephrology, Emma Children's Hospital AMC Amsterdam, The Netherlands. 2. 2 Department of Paediatric Cardiology, Emma Children's Hospital AMC Amsterdam, The Netherlands. 3. 3 Department of Paediatric Clinical Epidemiology, Emma Children's Hospital AMC Amsterdam, The Netherlands. 4. 4 Department of Paediatric Nephrology, University Hospital Leuven, Belgium. 5. 5 Department of Paediatric Cardiology, University Hospital Leuven, Belgium.
Abstract
INTRODUCTION: Early detection of cardiovascular disease in children with end-stage renal disease is essential in order to prevent cardiovascular morbidity and mortality in early adulthood. Tissue Doppler imaging has shown to be a promising method to detect and quantify subtle abnormalities in diastolic function. We therefore compared assessment of diastolic function by conventional echocardiography and tissue Doppler imaging. METHODS: We performed conventional echocardiography and tissue Doppler imaging in 38 children with end-stage renal disease and 76 healthy controls. We compared outcomes on parameters related to diastolic function (E/a ratio for conventional echocardiography and E/E' ratio for tissue Doppler imaging) for both groups using multiple linear regression analysis. Diastolic dysfunction was defined as E/a ratio <1 or E/E' ratio > 95th percentile for age. To assess the intra-observer reproducibility, the coefficient of variation was calculated. RESULTS: Children with end-stage renal disease had on average a lower E/a ratio (p = 0.004) and a higher mitral and septal E/E' ratio (both p < 0.001) compared with controls. In all, two children with end-stage renal disease (5%) had diastolic dysfunction according to the E/a ratio, 11 according to the mitral E/E' ratio (29%), and 16 according to the septal E/E' ratio (42%) compared with none of the controls (p = 0.109, p < 0.001, and p < 0.001, respectively). The coefficients of variation of the mitral (7%) and septal E/E' ratio (4%) were smaller than the coefficient of variation of the E/a ratio (11%). CONCLUSIONS: Tissue Doppler imaging is a more sensitive and reliable method to detect diastolic dysfunction than conventional E/a ratio in children with end-stage renal disease.
INTRODUCTION: Early detection of cardiovascular disease in children with end-stage renal disease is essential in order to prevent cardiovascular morbidity and mortality in early adulthood. Tissue Doppler imaging has shown to be a promising method to detect and quantify subtle abnormalities in diastolic function. We therefore compared assessment of diastolic function by conventional echocardiography and tissue Doppler imaging. METHODS: We performed conventional echocardiography and tissue Doppler imaging in 38 children with end-stage renal disease and 76 healthy controls. We compared outcomes on parameters related to diastolic function (E/a ratio for conventional echocardiography and E/E' ratio for tissue Doppler imaging) for both groups using multiple linear regression analysis. Diastolic dysfunction was defined as E/a ratio <1 or E/E' ratio > 95th percentile for age. To assess the intra-observer reproducibility, the coefficient of variation was calculated. RESULTS:Children with end-stage renal disease had on average a lower E/a ratio (p = 0.004) and a higher mitral and septal E/E' ratio (both p < 0.001) compared with controls. In all, two children with end-stage renal disease (5%) had diastolic dysfunction according to the E/a ratio, 11 according to the mitral E/E' ratio (29%), and 16 according to the septal E/E' ratio (42%) compared with none of the controls (p = 0.109, p < 0.001, and p < 0.001, respectively). The coefficients of variation of the mitral (7%) and septal E/E' ratio (4%) were smaller than the coefficient of variation of the E/a ratio (11%). CONCLUSIONS: Tissue Doppler imaging is a more sensitive and reliable method to detect diastolic dysfunction than conventional E/a ratio in children with end-stage renal disease.
Authors: Nabil Melhem; Alex Savis; Arran Wheatley; Helen Copeman; Kay Willmott; Christopher J D Reid; John Simpson; Manish D Sinha Journal: Pediatr Nephrol Date: 2019-05-16 Impact factor: 3.714
Authors: Charlotte Gimpel; Bernd A Jung; Sabine Jung; Johannes Brado; Daniel Schwendinger; Barbara Burkhardt; Martin Pohl; Katja E Odening; Julia Geiger; Raoul Arnold Journal: Pediatr Radiol Date: 2016-12-13
Authors: Maike van Huis; Nikki J Schoenmaker; Jaap W Groothoff; Johanna H van der Lee; Maria van Dyk; Marc Gewillig; Linda Koster; Ronald Tanke; Marc Lilien; Nico A Blom; Luc Mertens; Irene M Kuipers Journal: Pediatr Nephrol Date: 2016-05-17 Impact factor: 3.714