Progressive alterations of left atrial and ventricular volume and strain across chronic kidney disease stages: a speckle tracking echocardiography study

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Chien Van Do¹  Ha Thi Viet Dang²  Dieu Thi Vu Dang³  Loi Doan Do⁴  Hoai Thi Thu Nguyen⁵  Linh Huu Doan⁵ 

[1] Department of Cardiovascular Intensive Care Unit, 108 Military Central Hospital, Hanoi, Vietnam;Department of Internal Medicine, Hanoi Medical University, Hanoi, Vietnam;Center of Nephrology, Urology and Dialysis, Bach Mai Hospital, Hanoi, Vietnam;Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam;Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam;Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam;Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam;VNU University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam;

关键词: chronic kidney disease;    speckle tracking echocardiography;    left atrial strain;    left ventricular strain;    cardiovascular disease;   

DOI  :  10.3389/fcvm.2023.1197427

 received in 2023-03-31, accepted in 2023-08-11,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundIt has been a scarcity of evidence regarding differences in left ventricular (LV) and left atrial (LA) size and strain changes across stages of chronic kidney disease (CKD) and which echocardiographic parameters could be utilized to predict the decline of glomerular filtration rate (GFR).ObjectivesThis study aimed to evaluate the alterations of LV and LA strain across the reduction of renal function and potential echocardiographic parameters which could be correlated with the GFR decline among patients with CKD.MethodA cross-sectional study was conducted on 169 CKD patients at Bach Mai General Hospital, Hanoi, Vietnam from April to November 2022. Demographic, clinical and laboratory characteristics of patients were collected. Transthoracic echocardiography was performed to measure LV and LA size and strains. Jonckheere-Terpstra test was used to measure the tendency of change. Multivariate linear regression models were performed to find associations between different echocardiographic parameters and renal function reduction.ResultsThe number of patients with CKD stages 1, 2, 3, 4, and 5 was 21 (12.4%), 28 (16.6%), 27 (16.0%), 22 (13.0%) and 71 (42.0%), respectively. CKD severity was positively associated with LV diastolic and systolic diameters, LV mass, E/e' ratio, and maximal tricuspid regurgitation velocity (TR max), and negatively correlated with the LV global longitudinal strain. Higher severity of CKD stage was associated with higher LA diameter, LA strain, and volume in four and two-chamber views, and lower LA reservoir and conduit function. Left ventricular mass (β = 0.068), ejection fraction (β = 0.112) and left atrial reservoir (β = −0.077) were associated with reduced GFR.ConclusionLeft ventricular mass, ejection fraction, and atrial longitudinal strain by STE should be done at the earlier stages of CKD patients for better follow-up of GFR decline.

【 授权许可】

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© 2023 Nguyen, Do, Dang, Do, Doan and Dang.