Left ventricular global longitudinal strain is associated with cardiovascular risk factors and arterial stiffness in chronic kidney disease

BMC Nephrology

Nicole M. Isbel⁶  Brian A. Haluska⁴  Rodel Leano⁴  Jeff S. Coombes¹  Kassia S. Beetham¹  Ken-Soon Tan⁵  William Petchey²  Megan Rossi³  Katrina L. Campbell³  Elaine M. Pascoe³  Tony Stanton⁴  Carmel M. Hawley³  Rathika Krishnasamy⁶ 

[1] School of Human Movement Studies, The University of Queensland, Brisbane, Australia;Department of Renal Medicine, Cambridge University Hospital, Cambridge, England;Translational Research Institute, Brisbane, Australia;Cardiovascular Imaging Research Center, The University of Queensland at Princess Alexandra Hospital, Brisbane, Australia;School of Medicine, Griffith University, Brisbane, Australia;School of Medicine, The University of Queensland, Brisbane, Australia

关键词: Uremic toxins;    Obesity;    Arterial stiffness;    Global longitudinal strain;    Left ventricular function;   

Others  :  1220009
DOI  :  10.1186/s12882-015-0098-1

 received in 2014-10-28, accepted in 2015-06-25,  发布年份 2015

【 摘 要 】

Background

Global longitudinal strain (GLS) has emerged as a superior method for detecting left ventricular (LV) systolic dysfunction compared to ejection fraction (EF) on the basis that it is less operator dependent and more reproducible. The 2-dimensional strain (2DS) method is easily measured and integrated into a standard echocardiogram. This study aimed to determine the relationship between GLS and traditional and chronic kidney disease (CKD)-related risk factors of cardiovascular disease (CVD) in patients with CKD.

Methods

A cross sectional study of patients with moderate CKD stages 3 and 4 (n = 136). Clinical characteristics, anthropometric, biochemical data including markers of inflammation [C-reactive protein (CRP)], uremic toxins [indoxyl sulphate (IS), p-cresyl sulphate (PCS)], and arterial stiffness [pulse wave velocity (PWV)] were measured. Inducible ischemia was detected using exercise stress echocardiogram. GLS was determined from 3 standard apical views using 2-dimensional speckle tracking and EF was measured using Simpson’s rule. Associations between GLS and traditional and CKD-related risk factors were explored using multivariate models.

Results

The study population parameters included: age 59.4 ± 9.8 years, 58 % male, estimated glomerular filtration rate (eGFR) 44.4 ± 10.1 ml/min/1.73 m ² , GLS −18.3 ± 3.6 % and EF 65.8 % ± 7.8 %. This study demonstrated that GLS correlated with diabetes (r = 0.21, p = 0.01), history of heart failure (r = 0.20, p = 0.01), free IS (r = 0.24, p = 0.005) free PCS (r = 0.23, p = 0.007), body mass index (BMI) (r = 0.28, p < 0.001), and PWV (r = 0.24, p = 0.009). Following adjustment for demographic, baseline co-morbidities and laboratory parameters,GLS was independently associated with free IS, BMI and arterial stiffness (R ²for model = 0.30, p < 0.0001).

Conclusions

In the CKD cohort, LV systolic function assessed using GLS was associated with uremic toxins, obesity and arterial stiffness.

【 授权许可】

   
2015 Krishnasamy et al.

【 图 表 】

Fig. 1.

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