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, R., Hawley, C. M., Stanton, T., Pascoe, E. M., Campbell, K. L., Rossi, M., ... Isbel, N. M. (2015). Left ventricular global longitudinal strain is associated with cardiovascular risk factors and arterial stiffness in chronic kidney disease. BMC Nephrology, 16(1), 106. [106]. https://doi.org/10.1186/s12882-015-0098-1
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.
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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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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.

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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

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M1 - 106

ER -