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

Krishnasamy, Rathika, Hawley, Carmel M., Stanton, Tony, Pascoe, Elaine M., Campbell, Katrina L., Rossi, Megan, Petchey, William, Tan, Ken-Soon, Beetham, Kassia S., Coombes, Jeff S., Leano, Rodel, Haluska, Brian A. and Isbel, Nicole M. (2015) Left ventricular global longitudinal strain is associated with cardiovascular risk factors and arterial stiffness in chronic kidney disease. BMC Nephrology, 16 106: 1-9. doi:10.1186/s12882-015-0098-1


Author Krishnasamy, Rathika
Hawley, Carmel M.
Stanton, Tony
Pascoe, Elaine M.
Campbell, Katrina L.
Rossi, Megan
Petchey, William
Tan, Ken-Soon
Beetham, Kassia S.
Coombes, Jeff S.
Leano, Rodel
Haluska, Brian A.
Isbel, Nicole M.
Title Left ventricular global longitudinal strain is associated with cardiovascular risk factors and arterial stiffness in chronic kidney disease
Journal name BMC Nephrology   Check publisher's open access policy
ISSN 1471-2369
Publication date 2015-07-18
Year available 2015
Sub-type Article (original research)
DOI 10.1186/s12882-015-0098-1
Open Access Status DOI
Volume 16
Issue 106
Start page 1
End page 9
Total pages 9
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2016
Language eng
Formatted abstract
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 2 for 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.
Keyword Left ventricular function
Global longitudinal strain
Arterial stiffness
Obesity
Uremic toxins
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Human Movement and Nutrition Sciences Publications
School of Medicine Publications
 
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