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

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

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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 m(2), 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 (R(2) for model =  .30, p < 0.0001).

CONCLUSIONS: In the CKD cohort, LV systolic function assessed using GLS was associated with uremic toxins, obesity and arterial stiffness.

Original languageEnglish
Article number106
Pages (from-to)106
JournalBMC Nephrology
Volume16
Issue number1
DOIs
Publication statusPublished - 18 Jul 2015
Externally publishedYes

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Vascular Stiffness
Chronic Renal Insufficiency
Indican
Pulse Wave Analysis
Sulfates
Body Mass Index
Left Ventricular Dysfunction
Glomerular Filtration Rate
Left Ventricular Function
C-Reactive Protein
Cardiovascular Diseases
Ischemia
Heart Failure
Obesity
Cross-Sectional Studies
Demography
Exercise
Inflammation
Morbidity
Population

Cite this

Krishnasamy, Rathika ; Hawley, Carmel M ; Stanton, Tony ; Pascoe, Elaine M ; Campbell, Katrina L ; Rossi, Megan ; Petchey, William ; Tan, Ken-Soon ; Beetham, Kassia S ; Coombes, Jeff S ; Leano, Rodel ; Haluska, Brian A ; Isbel, Nicole M. / Left ventricular global longitudinal strain is associated with cardiovascular risk factors and arterial stiffness in chronic kidney disease. In: BMC Nephrology. 2015 ; Vol. 16, No. 1. pp. 106.
@article{fff86103b4344a4fbbb72cec20f92e16,
title = "Left ventricular global longitudinal strain is associated with cardiovascular risk factors and arterial stiffness in chronic kidney disease",
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 m(2), 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 (R(2) for model =  .30, p < 0.0001).CONCLUSIONS: In the CKD cohort, LV systolic function assessed using GLS was associated with uremic toxins, obesity and arterial stiffness.",
author = "Rathika Krishnasamy and Hawley, {Carmel M} and Tony Stanton and Pascoe, {Elaine M} and Campbell, {Katrina L} and Megan Rossi and William Petchey and Ken-Soon Tan and Beetham, {Kassia S} and Coombes, {Jeff S} and Rodel Leano and Haluska, {Brian A} and Isbel, {Nicole M}",
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language = "English",
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journal = "BMC Nephrology",
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Krishnasamy, R, Hawley, CM, Stanton, T, Pascoe, EM, Campbell, KL, Rossi, M, Petchey, W, Tan, K-S, Beetham, KS, Coombes, JS, Leano, R, Haluska, BA & Isbel, NM 2015, 'Left ventricular global longitudinal strain is associated with cardiovascular risk factors and arterial stiffness in chronic kidney disease' BMC Nephrology, vol. 16, no. 1, 106, pp. 106. https://doi.org/10.1186/s12882-015-0098-1

Left ventricular global longitudinal strain is associated with cardiovascular risk factors and arterial stiffness in chronic kidney disease. / Krishnasamy, Rathika; Hawley, Carmel M; Stanton, Tony; Pascoe, Elaine M; Campbell, Katrina L; Rossi, Megan; Petchey, William; Tan, Ken-Soon; Beetham, Kassia S; Coombes, Jeff S; Leano, Rodel; Haluska, Brian A; Isbel, Nicole M.

In: BMC Nephrology, Vol. 16, No. 1, 106, 18.07.2015, p. 106.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Left ventricular global longitudinal strain is associated with cardiovascular risk factors and arterial stiffness in chronic kidney disease

AU - Krishnasamy, Rathika

AU - Hawley, Carmel M

AU - Stanton, Tony

AU - Pascoe, Elaine M

AU - Campbell, Katrina L

AU - Rossi, Megan

AU - Petchey, William

AU - Tan, Ken-Soon

AU - Beetham, Kassia S

AU - Coombes, Jeff S

AU - Leano, Rodel

AU - Haluska, Brian A

AU - Isbel, Nicole M

PY - 2015/7/18

Y1 - 2015/7/18

N2 - 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 m(2), 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 (R(2) for model =  .30, p < 0.0001).CONCLUSIONS: In the CKD cohort, LV systolic function assessed using GLS was associated with uremic toxins, obesity and arterial stiffness.

AB - 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 m(2), 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 (R(2) for model =  .30, p < 0.0001).CONCLUSIONS: In the CKD cohort, LV systolic function assessed using GLS was associated with uremic toxins, obesity and arterial stiffness.

UR - http://www.scopus.com/inward/record.url?scp=84937574101&partnerID=8YFLogxK

U2 - 10.1186/s12882-015-0098-1

DO - 10.1186/s12882-015-0098-1

M3 - Article

VL - 16

SP - 106

JO - BMC Nephrology

JF - BMC Nephrology

SN - 1471-2369

IS - 1

M1 - 106

ER -