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Cardiac remodelling and functional alterations in mild‐to‐moderate renal dysfunction: comparison with healthy subjects
Author(s) -
Asp Anna M.,
Wallquist Carin,
Rickenlund Anette,
Hylander Britta,
Jacobson Stefan H.,
Caidahl Kenneth,
Eriksson Maria J.
Publication year - 2015
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/cpf.12154
Subject(s) - medicine , cardiology , kidney disease , diastole , left ventricular hypertrophy , doppler imaging , renal function , diastolic function , doppler echocardiography , blood pressure
Summary Introduction Left ventricular ( LV ) hypertrophy ( LVH ) and reduced LV function correlate with poor prognosis in patients with chronic kidney disease ( CKD ). Our aim is to investigate whether mild‐to‐moderate CKD is associated with cardiac abnormalities. Methods Echocardiography, including tissue Doppler imaging, was performed in 103 patients with CKD at stages 2–3 and 4–5, and in 53 healthy controls. The systolic ( s ′) and diastolic myocardial velocity ( e ′), and the transmitral diastolic flow velocity ( E ) were measured, and E / e ′ was calculated. Results Patients with chronic kidney disease had higher mean E / e ′ than controls (mean E / e ′: controls 5·00 ± 1·23 versus CKD 4–5 6·36 ± 1·71, P <0·001 and versus CKD 2–3 5·69 ± 1·47, P = 0·05), indicating altered diastolic function in the patients. The CKD groups showed lower longitudinal systolic function than controls, as assessed by atrio‐ventricular plane displacement and s ′ (mean s ′: controls 11·5 ± 1·9 cm s −1 versus CKD 4–5 10·4 ± 2·1 cm s −1 , P = 0·03 and versus CKD 2–3 10·4 ± 2·1 cm s −1 , P = 0·02). The prevalence of LVH was higher in patients with CKD than in controls (controls 13% versus CKD 4–5 37%, P = 0·006 and versus CKD 2–3 30%, P = 0·03). Conclusion Alterations in systolic and diastolic myocardial function can be seen in mild‐to‐moderate CKD compared with controls, indicating that cardiac involvement starts early in CKD , which may be a precursor of premature cardiac morbidity.