Association between left ventricular global longitudinal strain, health-related quality of life and functional capacity in chronic kidney disease patients with preserved ejection fraction.

Krishnasamy, Rathika, Hawley, Carmel M., Stanton, Tony, Howden, Erin J., Beetham, Kassia, Strand, Haakan, Leano, Rodel L., Haluska, Brian A., Coombes, Jeff S. and Isbel, Nicole M. (2016) Association between left ventricular global longitudinal strain, health-related quality of life and functional capacity in chronic kidney disease patients with preserved ejection fraction.. Nephrology, 21 2: 108-115. doi:10.1111/nep.12557


Author Krishnasamy, Rathika
Hawley, Carmel M.
Stanton, Tony
Howden, Erin J.
Beetham, Kassia
Strand, Haakan
Leano, Rodel L.
Haluska, Brian A.
Coombes, Jeff S.
Isbel, Nicole M.
Title Association between left ventricular global longitudinal strain, health-related quality of life and functional capacity in chronic kidney disease patients with preserved ejection fraction.
Journal name Nephrology   Check publisher's open access policy
ISSN 1320-5358
1440-1797
Publication date 2016-02
Sub-type Article (original research)
DOI 10.1111/nep.12557
Open Access Status Not Open Access
Volume 21
Issue 2
Start page 108
End page 115
Total pages 8
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2017
Language eng
Formatted abstract
Aim: Patients with Chronic Kidney Disease (CKD) have a significant burden of dyspnea and fatigue in spite having normal left ventricular (LV) ejection fraction (EF). Global longitudinal strain (GLS) can detect subtle changes in LV function. This study aimed to evaluate the relationship between LV function, functional capacity and quality of life (QOL) in CKD patients with preserved EF.

Methods: A cross sectional study of patients with stage 3/4 CKD (n=108). Clinical characteristics, biochemical data, functional capacity [6 minute walk test (6MWT), timed up and go (TUG) test] and QOL [Short Form-12 (SF-12v2™)] were measured. Echocardiogram was used to assess GLS, EF and diastolic function (E/A, e’ and E/e’).

Results: The mean age was 58.1±9.9 years, 55.6% were male, estimated Glomerular Filtration Rate (eGFR) was 44.8± 10.6 ml/min/1.73m2 GLS was -18.5 ± 3.6% and 19.4% had impaired GLS (>-16%). Patients with impaired GLS had a significantly shorter 6MWT and slower TUG test compared to patients with preserved GLS. Bivariate analysis showed GLS and E/e’ correlated with distance walked in 6MWT[GLS(r=-0.24,p=0.02); E/e’(r=-0.38,p=0.002)]. Following adjustment for potential confounders, GLS remained independently associated with 6MWT(Model R2=0.37, p<0.001).

Mean physical component summary scores (PCS) and mental component summary scores (MCS) were 43.0±10.2 and 50.9±9.5. There was no cardiac parameter that was independently associated with PCS. However females, lower systolic blood pressure and GLS was associated with lower MCS (Model R2=0.30, p<0.001).

Conclusion: GLS may be sensitive marker to detect early changes in effort tolerance and QOL in patients with preserved EF.
Keyword Left Ventricular Function
Global longitudinal strain
Ejection fraction
Quality of life
Functional capacity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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Created: Wed, 22 Jul 2015, 14:29:38 EST by Dr Haakan Strand on behalf of School of Nursing, Midwifery and Social Work