scholarly journals Left ventricular global longitudinal strain is associated with novel uraemic toxins, obesity and arterial stiffness in chronic kidney disease

2015 ◽  
Vol 24 ◽  
pp. S190
Author(s):  
T. Stanton ◽  
R. Krishnasamy ◽  
C. Hawley ◽  
E. Pascoe ◽  
K. Campbell ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Stiffness ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular

P6242Left ventricular global longitudinal strain to predict pulmonary edema in chronic kidney disease patients on haemodialysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Meenakshi ◽  
R Rameshwar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Ejection Fraction ◽  
Pulmonary Edema ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Group A ◽  
Group B

Abstract The left ventricular (LV) function remains preserved in the majority patients with chronic kidney disease (CKD). Despite this, Pulmonary edema can still occur in CKD patients with preserved ejection fraction during or after haemodialysis. The aim of our study was to determine whether assessment of Left ventricular global longitudinal strain (LV GLS) in CKD patients, could be used to detect sub clinical LV dysfunction and hence the propensity to develop pulmonary edema during or post hemodialysis. Our study cohort consisted of 105 CKD patients with normal Ejection fraction by transthoracic Echocardiography (TTE) and undergoing haemodialysis. There were 38 females and 67 males, ages ranging from 23 to 63yrs. They underwent detailed evaluation and assessment of risk factor profile, particularly the presence of hypertension and Diabetes. The Ejection fraction, presence of left ventricular hypertrophy (LVH), Left ventricular diastolic dysfunction (LVDD) and the LV GLS were assessed by TTE. Based on the findings, the male and female patients were divided into 3 groups. Group A with a GLS <−15, Group with a GLS between −15 and −18 and group C with GLS >−18. In group A, 81.1% of the males and 86.7% of the females developed pulmonary edema in contrast to 13% and 21.1% and 14.3% and 0% in groups B and C respectively. When LVDD was compared to the LV GLS it was found that in Group A, 80% of the males, and 88.2% of the females with LVDD developed pulmonary edema in contrast to 7% and 20% in group B and 0% and 0% in Group c respectively who had LVDD and developed pulmonary edema. In spite of having a normal LV diastolic function 100% of the males in group A developed pulmonary edema. Further, 92.8% of the males and 80% of the females in group B did not develop pulmonary edema despite having LVDD. So from our study, a cut of LV GLS value of −15 could predict pulmonary edema in CKD patients undergoing hemodialysis and although the majority were associated with LVDD, it could occur even in the absence of diastolic dysfunction. Further at LV GLS values >−15, the incidence of pulmonary edema was statistically significantly less despite having LVDD. Conclusion Left ventricular GLS appears to be a more reliable method than LVDD for predicting the occurrence of pulmonary edema during or post haemodialysis in CKD patients with normal LV Function, A LV GLS <15 would indicate the necessity for the implementation of appropriate precautions to prevent the occurrence of the same during dialysis. It can also be used in the long term follow up of patients.

scholarly journals PROGNOSTIC IMPLICATIONS OF LEFT VENTRICULAR GLOBAL LONGITUDINAL STRAIN IN STAGE 4 AND 5 CHRONIC KIDNEY DISEASE PATIENTS

2017 ◽  
Vol 69 (11) ◽  
pp. 1459 ◽  
Author(s):  
Liselotte C.R. Hensen ◽  
Kathleen Goossens ◽  
Joris Rotmans ◽  
Johan Jukema ◽  
Victoria Delgado ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Stage 4 ◽  
Prognostic Implications

scholarly journals The Association between Nitric Oxide Pathway, Blood Pressure Abnormalities, and Cardiovascular Risk Profile in Pediatric Chronic Kidney Disease

2019 ◽  
Vol 20 (21) ◽  
pp. 5301 ◽  
Author(s):  
Hsu ◽  
Lu ◽  
Lo ◽  
Lin ◽  
Tain
Keyword(s):  
Nitric Oxide ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Stiffness ◽  
Children And Adolescents ◽  
Young Patients ◽  
Left Ventricular ◽  
Stiffness Index ◽  
Lv Mass

Cardiovascular disease (CVD) is common in chronic kidney disease (CKD), while major CV events are rare in young CKD patients. In addition to nitric oxide (NO)-related biomarkers, several surrogate markers have been assessed to stratify CV risk in youth with CKD, including 24-h ambulatory blood pressure monitoring (ABPM), carotid artery intima-media thickness (cIMT), pulse wave velocity (PWV), ABPM-derived arterial stiffness index (AASI), flow-mediated dilatation (FMD), and left ventricular mass index (LVMI). The aim of this study was to identify subclinical CVD through the analysis of indices of CV risk in children and adolescents with CKD. Between 2016 and 2018, the prospective observational study enrolled 125 patients aged 3 to 18 years with G1–G4 CKD stages. Close to two-thirds of young patients with CKD exhibited blood pressure (BP) abnormalities on ABPM. CKD children with abnormal office BP showed lower plasma arginine levels and arginine-to-asymmetric dimethylarginine (ADMA) ratio, but higher ratios of ADMA-to-symmetric dimethylarginine (SDMA) and citrulline-to-arginine. High PWV and AASI, indices of arterial stiffness, both strongly correlated with high BP load. Additionally, LV mass and LVMI exhibited strong correlations with high BP load. Using an adjusted regression model, we observed the citrulline-to-arginine ratio was associated with 24-h systolic and diastolic BP, systolic blood pressure (SBP) load, and diastolic blood pressure (DBP) load. Early assessments of NO-related parameters, BP load abnormalities, arterial stiffness indices, and LV mass will aid in early preventative care toward decreasing CV risk later in life for children and adolescents with CKD.

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