Vector flow mapping analysis of left ventricular vortex performance in type 2 diabetic patients with early chronic kidney disease

BMC Cardiovascular Disorders

Research

Wei Wang¹  Zhengqin Qi²  Lijuan Sun²  Kun Xue²  Damin Lyu²  Xiaoxue Chen³  Fang Qiu⁴  Degang Song⁵ 

[1] Department of Cardiac Ultrasound, Second Hospital of Hebei Medical University, 215 Hepingxi Road, 050000, Shijiazhuang, Hebei, China;Department of Ultrasound, First Hospital of Qinhuangdao, Hebei Medical University, No.258, Wenhua Road, 066000, Qinhuangdao, Hebei, China;Department of Ultrasound, First Hospital of Qinhuangdao, Hebei Medical University, No.258, Wenhua Road, 066000, Qinhuangdao, Hebei, China;Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio- cerebrovascular Disease, No. 215, Hepingxi Road, 050000, Shijiazhuang, Hebei, China;Department of cardiology, First Hospital of Qinhuangdao, Hebei Medical University, No.258, Wenhua Road, 066000, Qinhuangdao, Hebei, China;Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio- cerebrovascular Disease, No. 215, Hepingxi Road, 050000, Shijiazhuang, Hebei, China;Department of neurology, First Hospital of Qinhuangdao, Hebei Medical University, No.258, Wenhua Road, 066000, Qinhuangdao, Hebei, China;

关键词: Left ventricular vortex;    Vector flow mapping;    Chronic kidney disease;    Diastolic dysfunction;    Glycemia;    Early stages;   

DOI  :  10.1186/s12872-023-03474-7

 received in 2023-03-20, accepted in 2023-08-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDiabetes is the leading cause of chronic kidney disease (CKD) and contributes to an elevated incidence of diastolic dysfunction in the early stages of CKD. Intracardiac vortex is a novel hemodynamic index for perceiving cardiac status. Here, we visualized left ventricular (LV) vortex characteristics using vector flow mapping (VFM) in type 2 diabetic patients with early CKD.MethodsThis cross-sectional study included 67 controls and 89 type 2 diabetic patients with stages 2-3a CKD. All subjects underwent transthoracic echocardiographic examination. LV anterior vortex during early diastole (E-vortex), atrial contraction (A-vortex) and systole (S-vortex) were assessed using VFM in the apical long-axis view. Its relation to glycemia or LV filling echocardiographic parameters were further analyzed using correlation analysis.ResultsType 2 diabetic patients with early CKD had a small area (439.94 ± 132.37 mm2 vs. 381.66 ± 136.85 mm2, P = 0.008) and weak circulation (0.0226 ± 0.0079 m2/s vs. 0.0195 ± 0.0070 m2/s, P = 0.013) of E-vortex, but a large area (281.52 ± 137.27 mm2 vs. 514.83 ± 160.33 mm2, P ˂ 0.001) and intense circulation (0.0149 ± 0.0069 m2/s vs. 0.0250 ± 0.0067 m2/s, P < 0.001) of A-vortex compared to controls. CKD patients with poorly controlled hyperglycemia had stronger A-vortex (area: 479.06 ± 146.78 mm2 vs. 559.96 ± 159.27 mm2, P = 0.015; circulation: 0.0221 ± 0.0058 m2/s vs. 0.0275 ± 0.0064 m2/s, P < 0.001) and S-vortex (area: 524.21 ± 165.52 mm2 vs. 607.87 ± 185.33 mm2, P = 0.029; circulation: 0.0174 ± 0.0072 m2/s vs. 0.0213 ± 0.0074 m2/s, P = 0.015), and a longer relative duration of S-vortex (0.7436 ± 0.0772 vs. 0.7845 ± 0.0752, P = 0.013) than those who had well-controlled hyperglycemia. Glycemia, and E/A (a LV filling parameter) were respectively found to had close correlation to the features of A-vortex and S-vortex (all P < 0.05).ConclusionsAbnormal LV vortices were detected in type 2 diabetic patients with early CKD using VFM, especially in those who neglected hyperglycemic control. LV vortex might be a promising parameter to slow or halt the hyperglycemia-induced diastolic dysfunction in early CKD.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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