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

Aim Patients with chronic kidney disease ( CKD ) have a significant burden of dyspnoea 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‐min walk test (6 MWT ), 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 men, estimated glomerular filtration rate was 44.8 ± 10.6  mL /min/1.73 m 2 , GLS was −18.5 ± 3.6% and 19.4% had impaired GLS (>−16%). Patients with impaired GLS had a significantly shorter 6 MWT and slower TUG test compared with patients with preserved GLS . Bivariate analysis showed GLS and E /e' correlated with distance walked in 6 MWT (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 6 MWT (model R 2  = 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 women, lower systolic blood pressure and GLS was associated with lower MCS (model R 2  = 0.30, P  < 0.001). Conclusion GLS was associated with measures of functional capacity and QOL in CKD patients with preserved EF .