Ruth Lagies1, Bodo B Beck2, Bernd Hoppe3, Sahar S Sheta4, Verena Weiß5, Narayanswami Sreeram1, Floris E A Udink ten Cate1. 1. Department of Pediatric Cardiology, Heart Center Cologne, University Hospital of Cologne, Cologne, Germany. 2. Institute of Human Genetics, University of Cologne, Cologne, Germany. 3. Department of Pediatrics, Division of Pediatric Nephrology, University of Bonn, Bonn, Germany. 4. Department of Pediatric Cardiology, Cairo University Children's Hospital (CUCH), Cairo, Egypt. 5. Institute for Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne, Cologne, Germany.
Abstract
BACKGROUND: Cardiac dysfunction frequently complicates the clinical course of patients with end-stage renal failure (ESRF). Recently, we observed abnormal longitudinal cardiac rotation (LR) among patients with ESRF. In this study, we sought to quantify LR mechanics in patients undergoing hemodialysis (HD). METHODS:Twenty-four subjects, 12 ESRF patients (58% male; age 17.5 ± 4.4 years) receiving HD, and 12 aged-matched controls, were prospectively studied. Patients underwent echocardiographic studies before and after HD. LR mechanics were quantified with two-dimensional speckle tracking echocardiography. Peak systolic left ventricular (LV) longitudinal strain and displacement measurements were obtained in all subjects. RESULTS:LR mechanics were successfully quantified in all subjects using 5 key echocardiographic features of LR. We identified two different inhomogeneous LR motion patterns in 41.7% of ESRF patients, characterized by a delayed timing of LR or increased segmental apical rotation. Inhomogeneous LR patterns were not found in controls. Timing of early-systolic counterclockwise LR increased after HD (P = 0.006). In patients, late-systolic clockwise LR occurred earlier (P = 0.043), and showed a significant prolongation after HD (P = 0.003). Longitudinal strain was significantly impaired in patients (P = 0.015), and further decreased after HD (P < 0.0001). Strong correlations were observed between strain and displacement parameters and LR mechanics. CONCLUSIONS: Quantifying LR using speckle tracking echocardiography was feasible, easy, and reproducible. Inhomogeneous LR motion patterns were demonstrated in a large proportion of patients with ESRF. LV dysfunction seems the most important determinant of inhomogeneous LR. Further studies are required to validate these findings.
RCT Entities:
BACKGROUND:Cardiac dysfunction frequently complicates the clinical course of patients with end-stage renal failure (ESRF). Recently, we observed abnormal longitudinal cardiac rotation (LR) among patients with ESRF. In this study, we sought to quantify LR mechanics in patients undergoing hemodialysis (HD). METHODS: Twenty-four subjects, 12 ESRF patients (58% male; age 17.5 ± 4.4 years) receiving HD, and 12 aged-matched controls, were prospectively studied. Patients underwent echocardiographic studies before and after HD. LR mechanics were quantified with two-dimensional speckle tracking echocardiography. Peak systolic left ventricular (LV) longitudinal strain and displacement measurements were obtained in all subjects. RESULTS: LR mechanics were successfully quantified in all subjects using 5 key echocardiographic features of LR. We identified two different inhomogeneous LR motion patterns in 41.7% of ESRF patients, characterized by a delayed timing of LR or increased segmental apical rotation. Inhomogeneous LR patterns were not found in controls. Timing of early-systolic counterclockwise LR increased after HD (P = 0.006). In patients, late-systolic clockwise LR occurred earlier (P = 0.043), and showed a significant prolongation after HD (P = 0.003). Longitudinal strain was significantly impaired in patients (P = 0.015), and further decreased after HD (P < 0.0001). Strong correlations were observed between strain and displacement parameters and LR mechanics. CONCLUSIONS: Quantifying LR using speckle tracking echocardiography was feasible, easy, and reproducible. Inhomogeneous LR motion patterns were demonstrated in a large proportion of patients with ESRF. LV dysfunction seems the most important determinant of inhomogeneous LR. Further studies are required to validate these findings.
Authors: Ruth Lagies; Floris E A Udink Ten Cate; Markus Feldkötter; Bodo B Beck; Narayanswami Sreeram; Bernd Hoppe; Ulrike Herberg Journal: Pediatr Nephrol Date: 2019-08-22 Impact factor: 3.714
Authors: David J Sas; Felicity T Enders; Tina M Gunderson; Ramila A Mehta; Julie B Olson; Barbara M Seide; Carly J Banks; Bastian Dehmel; Patricia A Pellikka; John C Lieske; Dawn S Milliner Journal: Front Med (Lausanne) Date: 2021-04-09
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