Left ventricular twist mechanics and its relation with aortic stiffness in chronic kidney disease patients without overt cardiovascular disease

Cardiovascular Ultrasound

Research

Vasileios F. Panoulas¹  Athanasios Bratsas¹  Klio Konstantinou¹  Petros Nihoyannopoulos²  Samir Sulemane²  Edwina A. Brown³  Frederick W. Tam³ 

[1] Imperial College Healthcare NHS, Hammersmith Hospital, Ducane road, W12 0HP, London, UK;Imperial College London, National Heart and Lung Institute, Sydney Street, SW6 3NP, London, UK;Imperial College Renal and Transplant Centre, Hammersmith Hospital, Ducane road, W12 0HP, London, UK;

关键词: Chronic kidney disease;    LV twist;    Speckle tracking echocardiography;    Arterial stiffness;    Aortic pulse wave velocity;   

DOI  :  10.1186/s12947-016-0053-8

 received in 2015-12-17, accepted in 2016-03-02,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundRecent studies hypothesized left ventricular (LV) twist as a potential biomarker for evaluation of sub clinical myocardial disease, however its relationship with aortic stiffness has yet to be investigated. Chronic kidney disease (CKD) has been identified as a risk factor for both myocardial and arterial disease. As such we sought to explore the relationship between aortic stiffness and LV twist in CKD patients without known cardiovascular disease (CVD).MethodsIn this prospective, observational study we enrolled 106 CKD patients (Stages 1 to 5) with normal LVEF as assessed by conventional echocardiography. Aortic stiffness was measured using aortic pulse wave velocity (aPWV). We defined increased aPWV as ≥10 m/s. LV Twist was measured using two-dimensional speckle tracking echocardiography.ResultsPatients with increased aPWV had higher LV twist (p = 0.002) but similar LVEF (p = 0.486). Aortic PWV correlated crudely with age (p < 0.001), the presence of diabetes (p < 0.001), hypertension (p < 0.001), eGFR (p < 0.001), LVMI (p = 0.01), e/e’ (p < 0.001) and LV twist (p = 0.003). In multivariable analyses after adjusting for age, gender, cardiovascular risk factors and hypertensive medication, aPWV was independently associated with LV twist (β = 0.163, p = 0.025).ConclusionsAortic stiffness independently associates with LV Twist in asymptomatic CKD patients. These findings suggest a close interaction between LV twist mechanics and arterial remodeling even before CVD becomes clinically relevant.

【 授权许可】

CC BY   
© Sulemane et al. 2016