Investigation of Left Ventricular Layer-Specific Strain in Patients of Chronic Kidney Disease by 2-Dimensional Speckle Tracking Echocardiography

IF 3.2 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

American Journal of Hypertension Pub Date : 2024-08-14 DOI:10.1093/ajh/hpae052

Li-yun Fu, Qian-yi Zhang, Qin-yun Ruan, Hui-mei Huang, Lei Yan, Zi-ling You, Hong-da Su

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Abstract

OBJECTIVE To investigate the characteristics of left ventricular layer-specific strain in patients with chronic kidney disease (CKD). METHODS Eighty-five patients of chronic kidney disease in the Department of Nephrology of our hospital from March 2020 to August 2021 were selected and divided into three groups according to the estimated GFR: Group A (CKD stage 1–2), Group B (CKD stage 3–4), and Group C (CKD stage 5), 40 hypertensive patients without renal insufficiency were gathered as hypertension (HT) group and 40 gender and age-matched healthy volunteers were selected as the control group. Then, (i) Routine echocardiographic parameters: left ventricular diameter, left atrium diameter, wall thickness, LVEF. (ii) Myocardial strain: global longitudinal strain (GLS), longitudinal strain in endocardium (SL-endo), longitudinal strain in average (SL-ave), longitudinal strain in epicardium (SL-epi), global circumferential strain (GCS), global circumferential strain in endocardium (SC-endo), global circumferential strain in average (SC-ave), global circumferential strain in epicardium (SC-epi), and global radial strain (GRS) were analyzed. RESULTS (i) Compared with the control group, the structure of the left heart and LVEF in groups A and B had no significant changes, left ventricular remodeling appeared, and diastolic function declined in HT group and group C, LVEF decreased in group C (all P < 0.05). (ii) Only SL-endo decreased in the HT group. All of SL-endo, SL-ave, and SL-epi were reduced in the CKD group and were lowest in group C. Radial strain decreased only in group C (all P < 0.05). (iii) The global and layer-specific longitudinal strain were correlated with estimated glomerular filtration rate (eGFR) (r = 0.541–0.559, all P < 0.05), LVEF was correlated with longitudinal and circumferential strain (r = 0.406–0.424, all P < 0.05). Multiple linear regression analysis showed that longitudinal strain in different layers were independently correlated with different stages of CKD and the occurrence of secondary hypertension or not (β = −0.251 to −0.443, all P < 0.05). Circumferential strain in all layers were independently correlated with the appearance of secondary hypertension or not (β = −0.255 to −0.31, all P < 0.05). CONCLUSIONS The degree and range of the impairment of left ventricular strain in CKD patients are related to the stage of eGFR and secondary hypertension, which may affect the global systolic pump function by involving the circumferential strain.

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二维斑点追踪超声心动图对慢性肾病患者左心室各层特异性应变的研究

摘要] 目的探讨慢性肾脏病（CKD）患者左心室各层特异性应变的特点。方法选取我院肾内科 2020 年 3 月至 2021 年 8 月收治的 85 例慢性肾脏病患者，根据估算的 GFR 分为三组：A 组（CKD 1-2 期）、B 组（CKD 3-4 期）、C 组（CKD 5 期），40 例无肾功能不全的高血压患者为高血压组（HT），40 例性别、年龄匹配的健康志愿者为对照组。然后，(i) 常规超声心动图参数：左心室直径、左心房直径、室壁厚度、LVEF。(ii) 分析心肌应变：全局纵向应变（GLS）、心内膜纵向应变（SL-endo）、平均纵向应变（SL-ave）、心外膜纵向应变（SL-epi）、全局周向应变（GCS）、心内膜周向应变（SC-endo）、平均周向应变（SC-ave）、心外膜周向应变（SC-epi）和全局径向应变（GRS）。结果 (i) 与对照组相比，A 组和 B 组的左心结构和 LVEF 无明显变化，HT 组和 C 组出现左心室重构，舒张功能下降，C 组 LVEF 下降（均 P<0.05）。(ii) HT 组仅 SL-endo 下降。CKD组的SL-endo、SL-ave和SL-epi均下降，C组最低。径向应变仅在 C 组下降（所有 P 均为 0.05）。(iii) 整体和各层特异性纵向应变与估计肾小球滤过率（eGFR）相关（r = 0.541-0.559，均为 P &p;lt;0.05），LVEF 与纵向和周向应变相关（r = 0.406-0.424，均为 P &p;lt;0.05）。多元线性回归分析表明，各层的纵向应变与 CKD 的不同分期以及是否发生继发性高血压独立相关（β = -0.251 至 -0.443，均为 P &;lt;0.05）。各层的环向应变与继发性高血压的出现与否独立相关（β = -0.255 至 -0.31，所有 P 均为 0.05）。结论 CKD 患者左心室应变受损的程度和范围与 eGFR 分期和继发性高血压有关，而 eGFR 分期和继发性高血压可能会涉及周向应变，从而影响整体收缩泵功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Hypertension 医学-外周血管病

CiteScore

6.90

自引率

6.20%

发文量

144

审稿时长

3-8 weeks

期刊介绍： The American Journal of Hypertension is a monthly, peer-reviewed journal that provides a forum for scientific inquiry of the highest standards in the field of hypertension and related cardiovascular disease. The journal publishes high-quality original research and review articles on basic sciences, molecular biology, clinical and experimental hypertension, cardiology, epidemiology, pediatric hypertension, endocrinology, neurophysiology, and nephrology.