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Open Access 01-12-2015 | Research article

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

Authors: Rathika Krishnasamy, Carmel M. Hawley, Tony Stanton, Elaine M. Pascoe, Katrina L. Campbell, Megan Rossi, William Petchey, Ken-Soon Tan, Kassia S. Beetham, Jeff S. Coombes, Rodel Leano, Brian A. Haluska, Nicole M. Isbel

Published in: BMC Nephrology | Issue 1/2015

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 m², 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 (R² 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.

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Title: Left ventricular global longitudinal strain is associated with cardiovascular risk factors and arterial stiffness in chronic kidney disease
Authors: Rathika Krishnasamy
Carmel M. Hawley
Tony Stanton
Elaine M. Pascoe
Katrina L. Campbell
Megan Rossi
William Petchey
Ken-Soon Tan
Kassia S. Beetham
Jeff S. Coombes
Rodel Leano
Brian A. Haluska
Nicole M. Isbel
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Nephrology / Issue 1/2015
Electronic ISSN: 1471-2369
DOI: https://doi.org/10.1186/s12882-015-0098-1

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

Abstract

Background

Methods

Results

Conclusions

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