Echocardiographic assessment of cardiac structure and function in chronic renal disease

Dohi, Kaoru

doi:10.1007/s12574-019-00436-x

Cited by 17 publications

(28 citation statements)

References 61 publications

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“…Furthermore, the increase of myocardial collagen content and myocardial stiffness in early-stage CKD cause a reduction of active myocardial relaxation, then lead to a deterioration of diastolic function and a raise of filling pressure [ 26 ]. E/e’ ratio was reported to have quality to predict left ventricular filling pressure [ 27 ] and be a sensitive tool to detect diastolic function [ 28 ]. In our study, the patients with stages 1–3 CKD had increased E/e’ ratio, which was consistent with the previous data [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of left ventricular energy loss using vector flow mapping in patients with stages 1–3 chronic kidney disease

Chen

Wang

et al. 2020

BMC Cardiovasc Disord

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Background: Patients with chronic kidney disease (CKD) experience abnormality of intracardiac blood flow status during early-stages of disease. Left ventricular energy loss (EL) derived from vector flow mapping (VFM) represents fluid energy lost as heat in left ventricle and had been used to detect intracardiac blood flow efficiency. We aimed to evaluate the left ventricular EL in stage 1-3 CKD patients, and explored whether hypertension, a main cardiovascular risk, deteriorate the abnormality of intracardiac blood flow status. Methods: Transthoracic echocardiography was performed in 41 controls and 48 patients with stages 1-3 CKD. CKD patients consisted a subgroup with no hypertension, a subgroup with well-controlled hypertension and a subgroup with poorly controlled hypertension. The EL were calculated in the left ventricle using VFM analysis from the apical 3-chamber view. Furthermore, the correlation and stepwise multiple regression analysis were used to explore the potential independent predictors of left ventricular EL. Results: Compared with controls, stage 1-3 CKD patients showed increased left ventricular EL during total diastole, late diastole, total systole, isovolumic contraction and ejection. CKD patients with poorly controlled hypertension had higher left ventricular EL compared to the other CKD subgroups. Additionally, the ratio of mitral early filling wave peak velocity and early mitral annular peak velocity on septal side, mitral early filling wave peak velocity, and left ventricular mass index were independent predictors of the diastolic EL; whereas systolic blood pressure and left ventricular mass index were independent predictors of the systolic EL. Conclusions: Left ventricular EL was a useful echocardiographic parameter to evaluate the impaired intracardiac blood flow efficiency in patients with stages 1-3 CKD. Hypertension was a crucial contributor for intracardiac blood flow abnormality. This study might provide valuable clinical data to discern cardiac dysfunction and reduce the cardiovascular risk in early-stage CKD.

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Section: Discussionmentioning

confidence: 99%

Assessment of left ventricular energy loss using vector flow mapping in patients with stages 1–3 chronic kidney disease

Chen

Wang

et al. 2020

BMC Cardiovasc Disord

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“…Furthermore, CVD is responsible for approximately 39% of deaths among dialysis patients 1 . Different studies have emphasized the prognostic role for survival and adverse CV outcomes of left ventricle (LV) hypertrophy, both LV and right ventricle (RV) systolic dysfunction and dyssynchrony, as well as LV diastolic function in CKD patients 2–6 . Moreover, in a large retrospective cohort study including 29,219 patients, RV parameters were independently associated with adverse renal outcomes 7 .…”

Section: Introductionmentioning

confidence: 99%

Left atrial strain: A novel “biomarker” for chronic kidney disease patients?

et al. 2021

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Cardiovascular disease and chronic kidney disease are frequently inter‐connected and this association leads to an exponential growth of cardiovascular risk. This risk is currently underestimated by the existing algorithms and there is a constant need for new markers to predict adverse outcomes in this special population. In general population left atrial strain has emerged as an important tool for both the diagnosis and prognostic stratification, but data regarding its role in chronic kidney disease patients is scarce. The purpose of this review is to summarize the current evidence regarding this matter. Left atrial size and function mirror the duration and severity of increased left ventricular filling pressures. Increased left atrial volume index and impaired left atrial strain parameters are independent predictors for adverse cardiovascular events. Left atrial strain is impaired before changes in volume appear, thus being able to predict both diastolic and systolic function in chronic kidney disease patients. Finally, left atrial strain can identify renal patients with impaired exercise capacity and this could have clinical applications in the rehabilitation of this patients.

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“…Με απηφλ ηνλ ηξφπν θαζπζηεξείηαη ε εμέιημε ηεο λεθξηθήο λφζνπ θαη θαηά ζπλέπεηα απμάλεηαη ην πξνζδφθηκν λεθξηθήο επηβίσζεο ησλ αζζελψλ. (191,192,208 (28,193,195,196,198,208,(229)(230)(231)(232)(233)(234)(235)(236)(237)(238)(239)…”

Section: αιβνπκηλνπξίαunclassified

Στεφανιαία Εφεδρεία Ροής Και Διαστολική Απόδοση Της Αριστερής Κοιλίας Σε Ασθενείς Με Χρόνια Νεφρική Νόσο

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lntroduction-Aim of the studv: Chronic kidney disease (CKD) is related to higher risk for cardiovasular related morbidity and mortality. lt seems that this risk is higher even in the presence of early abnormal indices related to functionality of the left ventricle orland abnormal coronary flow reserve (CFR). Aim of this study was a) to investigate diastolic dysfunction and CFR after dipyridamole infusion in CKD patients, b) to inspect changes in diastolic dysfunction of the left ventricle after dipyridamole infusion in these patients and c) to compare the aforementioned indices between CKD patients and healthy controls, as also between patients with CKD and patients with a hisotry of renal transplantation Tx. Materials and methods: This study included 60 CKD patients from the outpatient CKD clinic of University Hospital of loannina, 30 healthy controls and 50 patients with Tx history. All patients and healthy controls were evaluated thoroughly (clinical examination, lab exams and echocardiographic evaluation). The echocardiographic evaluation included transthoracic echocardiogram, dipyridamole infusion for coronary flow reserve (CFR) evaluation in the left anterior descending coronary artery and at the end of the this stress test, a new transthoracic echocardiogram.ln a subgroup of Tx patients, the whole evaluation was repeated after 3 years. Results: Mean CFR value [t standard deviation (SD)] for CKD patients was 2.98 (t0.83).Deformation related echocardiographic indices urere normal [mean values (t) SD: GLS -20.5 (t3.1)o/o, τWlsT s.07(t4.41)", UNTW|Sτ -69.2(t30)"/sec]' Patients with advanced CKD (GFR<3omllminl1'73m2), had bigger left ventricle mass (p<0.037), without any other differences comparing to other patients as far as echocardiographic indices related to systolic and diastoliο left ventricular function were concerned. CKD patients had lower CFR comparing to healthy controls. There \rvere no differences of statistical importance between these two populations, in left ventricular functional indices. After dipyridamole infusion, there was a significant improvement (p<0.05) in all left venticular functionality related echoοardiographic indices in both populations.Tx patients had bigger left atrial volume (p=0.014), lower CFR mean value (p=0.007) and better left ventricular diastolic function shown by UΝTW|SΤ (p=0.035) comparing to CKD patients. There ιΛ/ere no differenοes in echocardiographic indices'changes before and after dipyridamole infusion. ln Tx patients that were re-evaluated after 3 years (N=45), a deterioration was shown in most of echocardiographic indices [increase in left ventricuΙat mass (ρ=0.009), decrease in left ventricular ejection fraction (p=0.001), increase in E/e'(p=0.002), deterioration in TW|ST (p=0.002) and UNTW|ST (p=9.935μ. Conclusion: Patients with CKD have lower CFR values comparing to healthy controls and higher than patients with a history of Tx. Tx patients had better left ventricular diastolic function than CKD patients. There \Λrere no significant differrences in various echocardiographiο indices before and after dipyridamole infusion, in all subgroups of patients in this study. Larger-scale studies are mandatory to clarify the clinical importance of various echocardiographic indices in different CKD stages.

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Echocardiographic assessment of cardiac structure and function in chronic renal disease

Cited by 17 publications

References 61 publications

Assessment of left ventricular energy loss using vector flow mapping in patients with stages 1–3 chronic kidney disease

Assessment of left ventricular energy loss using vector flow mapping in patients with stages 1–3 chronic kidney disease

Left atrial strain: A novel “biomarker” for chronic kidney disease patients?

Στεφανιαία Εφεδρεία Ροής Και Διαστολική Απόδοση Της Αριστερής Κοιλίας Σε Ασθενείς Με Χρόνια Νεφρική Νόσο

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