Cardiac remodelling and functional alterations in mild-to-moderate renal dysfunction: comparison with healthy subjects.

Clin Physiol Funct Imaging 2015 May 21;35(3):223-30. Epub 2014 Apr 21.

Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

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.

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http://dx.doi.org/10.1111/cpf.12154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4405083PMC
May 2015
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References

(Supplied by CrossRef)
Evaluation of echocardiographic indices for the prediction of major adverse events during long-term follow-up in chronic hemodialysis patients with normal left ventricular ejection fraction
Dogan et al.
Eur Rev Med Pharmacol Sci 2012

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