Impaired longitudinal deformation measured by speckle-tracking echocardiography in children with end-stage renal disease

Huis, Maike van; Schoenmaker, Nikki J.; Groothoff, Jaap W.; Lee, Johanna H. van der; Dyk, Maria van; Gewillig, Marc; Köster, Linda; Tanke, Ronald B.; Lilien, Marc R.; Blom, Nico A.; Mertens, Luc; Kuipers, Irene M.

doi:10.1007/s00467-016-3362-0

Cited by 24 publications

(30 citation statements)

References 48 publications

(44 reference statements)

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“…LV hypertrophy, which is observed even in early stage CKD [33], is mainly caused by hypertrophic responses in the mid-myocardial layers that are predominantly circumferentially orientated. This compensates for the reduction in longitudinal function and may explain preserved LVEF and GCS [41] in our cohort.…”

Section: Discussionmentioning

confidence: 82%

Subclinical markers of cardiovascular disease predict adverse outcomes in chronic kidney disease patients with normal left ventricular ejection fraction

Sulemane

Panoulas

Bratsas

et al. 2017

Int J Cardiovasc Imaging

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Emerging cardiovascular biomarkers, such as speckle tracking echocardiography (STE) and aortic pulse wave velocity (aPWV), have recently demonstrated the presence of subclinical left ventricular dysfunction and arterial stiffening in patients with chronic kidney disease (CKD) and no previous cardiovascular history. However, limited information exists on the prognostic impact of these biomarkers. We aimed to investigate whether STE and aPWV predict major adverse cardiac events (MACE) in this patient population. In this cohort study we prospectively analysed 106 CKD patients with no overt cardiovascular disease (CVD) and normal left ventricular ejection fraction. Cardiac deformation was measured using STE while aPWV was measured using arterial tonometry. The primary end-point was the composite of all-cause mortality, acute coronary syndrome, stable angina requiring revascularization (either using percutaneous coronary intervention or coronary artery bypass surgery), hospitalization for heart failure and stroke. Over a median follow up period of 49 months (interquartile range 11–63 months), 26 patients (24.5%) reached the primary endpoint. In a multivariable Cox hazards model, global longitudinal strain (GLS) (HR 1.12, 95% CI 1.02–1.29, p = 0.041) and aPWV (HR 1.31, 95% CI 1.05–1.41, p = 0.021) were significant, independent predictors of MACE. GLS and aPWV independently predict MACE in CKD patients with normal EF and no clinically overt CVD.

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Section: Discussionmentioning

confidence: 82%

Subclinical markers of cardiovascular disease predict adverse outcomes in chronic kidney disease patients with normal left ventricular ejection fraction

Sulemane

Panoulas

Bratsas

et al. 2017

Int J Cardiovasc Imaging

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“…Intra-observer reproducibility for the offline strain measurements by the same pediatric cardiologist (IMK) has previously proven to be good. 28 Other articles also reveal a good reproducibility for the longitudinal LV strain measurements. 29…”

Section: Speckle-tracking Echocardiographymentioning

confidence: 95%

“…[24][25][26][27] Longitudinal LV strain measurements were performed based on previous reported protocols to measure end-systolic strain. 28 Manual off-line tracing of the endocardial LV border was done during end-systole for the following six segments: apical septum, mid septum, basal septum and apical lateral, mid lateral, basal lateral. Segments were automatically approved or rejected by the program and subsequently needed manual approval.…”

Section: Speckle-tracking Echocardiographymentioning

confidence: 99%

Cardiac disease in mucopolysaccharidosis type III

Nijmeijer

Bruin‐Bon

Wijburg

et al. 2019

J of Inher Metab Disea

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Mucopolysaccharidosis type III (MPS III; Sanfilippo disease) is primarily characterized by neurocognitive decline with limited somatic disease. Only few reports addressed cardiac disease (CD) in MPS III. We investigated the prevalence of CD in a relatively large cohort of patients. In this cross‐sectional study, extensive echocardiographic studies were performed in 30 MPS III patients (16 patients <18 years), all without clinical symptoms of CD. Results were compared to data from matched controls. The mean global longitudinal strain on speckle‐tracking echocardiography (STE) was impaired in both pediatric and adult patients vs controls (resp. −18.4% vs −20.7%; mean difference 2.25, 95% CI 0.61‐3.89, P = 0.009 and −16.9% vs −19.5%; mean difference 2.64, 95% CI 0.78‐4.49, P = 0.007), indicating early systolic dysfunction. Left ventricle ejection fraction (LVEF) was normal in pediatric patients and (slightly) impaired in adult patients vs controls (48.7% vs 55.8%, P = 0.002). Tissue Doppler imaging (TDI) showed significantly slower early diastolic velocities (e′) compared to controls indicative for diastolic dysfunction. Furthermore, mitral and aortic valve abnormalities were prevalent (43% and 33% of patients, respectively). Finally, 15.6% of the patients had a first‐degree atrioventricular block on electrocardiography (ECG). The impaired STE reveals early, subclinical LV dysfunction which is supported by results of TDI. In addition, mild valvular disease and ECG abnormalities are prevalent. The lowered LVEF in adult patients suggests that the LV dysfunction is progressive, and may ultimately lead to clinical myocardial disease when patients live longer due to an effective disease‐modifying treatment of which a number of options are now in clinical trials.

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“…The development of two-dimensional (2D) speckle tracking echocardiography (STE) has facilitated the simple and angle-independent measurement of LV myocardial deformation in the longitudinal, circumferential, and radial directions, which can be used to detect subclinical uremic cardiomyopathy when LVEF is normal [7, 8]. LV strain has been proposed as a novel indication of systolic function.…”

Section: Introductionmentioning

confidence: 99%

Early Left Ventricular Dysfunction Detected by Speckle Tracking in Long-Term Hemodialysis Patients with Valvular Calcification

Li¹,

Li²,

Wang³

et al. 2018

Cardiorenal Med

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Purpose: Cardiac valve calcification (VC) is very common in patients on hemodialysis. However, the definite effect of VC on left ventricular (LV) geometry and function in this population is unknown, especially when LV ejection fraction (LVEF) is normal. The aim of this study was to determine the effect of VC on LV geometry and function in long-term hemodialysis patients by conventional echocardiography and two-dimensional speckle tracking echocardiography (2D-STE). Methods: A total of 47 hemodialysis patients (2–3 times weekly for 5 years or more) were enrolled in this study. Cardiac VC was defined as bright echoes of more than 1 mm on one or more cusps of the aortic valve or mitral valve or mitral annulus using echocardiography as the screening method. LV longitudinal global strain (GLS) was assessed on the apical four-chamber view and calculated as the mean strain of 6 segments. LV global circumferential strain was acquired on the LV short axis view at the level of papillary muscles. Results: Twenty-five patients with VC had higher mean values of interventricular septum thickness, LV posterior wall thickness, LV mass index, relative wall thickness, and LV mass/end-diastolic volume than 22 patients without VC (p < 0.05, respectively), indicating more obvious LV hypertrophy (LVH). VC patients had higher mitral annular E/E′ values, especially at the septal side representing increased LV filling pressure compatible with diastolic dysfunction, while only the E/E′ ratio of the septal side was significantly different between the 2 groups (16.7 ± 4.1 vs. 12.3 ± 4.4, p < 0.01). When assessed by GLS, LV longitudinal systolic function was also lower in in patients with VC compared with those without VC (–0.18 ± 0.03 vs. –0.25 ± 0.04; p < 0.01). Conclusions: Cardiac VC diagnosed by echocardiography when it occurs in long-term hemodialysis patients may indicate more severe LVH, myocardial damage, and worse heart function in comparison to those without VC. Tissue Doppler imaging and 2D-STE can detect the subtle change of heart function in this population in the early stage of LV dysfunction when LVEF is normal.

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Impaired longitudinal deformation measured by speckle-tracking echocardiography in children with end-stage renal disease

Cited by 24 publications

References 48 publications

Subclinical markers of cardiovascular disease predict adverse outcomes in chronic kidney disease patients with normal left ventricular ejection fraction

Subclinical markers of cardiovascular disease predict adverse outcomes in chronic kidney disease patients with normal left ventricular ejection fraction

Cardiac disease in mucopolysaccharidosis type III

Early Left Ventricular Dysfunction Detected by Speckle Tracking in Long-Term Hemodialysis Patients with Valvular Calcification

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