Correlation Between Diastolic Dysfunction and Exercise Capacity in Chronic Kidney Disease

Gan, G.; Kadappu, K.; Boyd, Anita; Goonetilleke, N.; Eshoo, S.; Thomas, Liza

doi:10.1016/j.hlc.2017.06.486

Cited by 1 publication

(2 citation statements)

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“…The prevalence of reduced left atrial strain begins to increase at the early stages of CKD in adults, and continues to rise at more advanced stages and ESKD 18 . In addition to the high prevalence of abnormal left atrial strain in adults with CKD, studies have revealed the clinical and prognostic utility of left atrial strain within CKD populations 4,19,20 . LASr was found to be the most accurate echocardiographic predictor of exercise intolerance in a study of adults with CKD 19 .…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the high prevalence of abnormal left atrial strain in adults with CKD, studies have revealed the clinical and prognostic utility of left atrial strain within CKD populations 4,19,20 . LASr was found to be the most accurate echocardiographic predictor of exercise intolerance in a study of adults with CKD 19 . Furthermore, compared to left ventricular global longitudinal strain, E/e' ratio, and LA volume, LASr was a stronger predictor of patients at risk for a composite cardiovascular outcome and death 4 .…”

Section: Discussionmentioning

confidence: 99%

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Left Atrial Mechanics in Youth with Chronic Kidney Disease and Similarly Aged Healthy-Controls

Kula,

Frisby-Zedan,

Linder

et al. 2024

Preprint

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Introduction: In adults with chronic kidney disease (CKD), abnormal left atrial reservoir strain (LASr) is an early, yet clinically significant, indicator of myocardial dysfunction. However, left atrial mechanics are understudied in youth with CKD. The objective of this study was to assess left atrial strain function in youth with CKD and similarly aged, healthy controls. Methods: We performed a single-center, retrospective, observational study of persons aged 12-21 years with stage 3-4 CKD and healthy controls. Exclusion criteria included a history of a kidney or other solid organ transplant, congenital heart disease, and/or dialysis requirement <3 months prior. We measured LAS (LASr, conduit, contractile), E/e’, E/A, left ventricular mass index (LVMI), and ejection fraction. Pearson correlations were performed between echocardiographic measures. Results: This study included 37 patients with CKD and 19 controls. Mean age was similar between groups and male sex was over-represented in both groups (CKD: 62%, Healthy: 63%). Mean ± standard deviation (SD) eGFR in the CKD group was 32 ±14mL/min/1.73m2. Mean absolute LASr was significantly lower in those with CKD (43.0 ±8.5%) compared to healthy controls (47.4 ±6.1%). Patients with CKD had significantly higher LVMI, and lower E/A and E’ compared to controls. There was poor correlation between LASr with E/A, E/e’, and LVMI. Conclusions: As observed in adults with CKD, LASr was significantly lower in youth with CKD compared to healthy controls. Moreover, LASr poorly correlated with traditional measures of diastolic dysfunction such as E/e’ and E/A.

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