Association Between Myocardial Work and Coronary Artery Calcium Score in Patients With Chronic Kidney Disease

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2024-12-30 DOI:10.1111/echo.70064

Flemming Javier Olsen, Nino Emanuel Landler, Jacob Christensen, Klaus Fuglsang Kofoed, Bo Feldt-Rasmussen, Ditte Hansen, Christina Christoffersen, Ellen Linnea Freese Ballegaard, Ida Maria Hjelm Sørensen, Sasha Saurbrey Bjergfelt, Eline Seidelin, Susanne Bro, Tor Biering-Sørensen

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Abstract

Background

Myocardial work is a novel measure of potential value for diagnosing coronary artery disease (CAD). It may therefore be useful in patients with chronic kidney disease (CKD), in whom the diagnostic work-up can be challenging.

Methods

This was a cross-sectional study of patients with CKD (G1-5, nondialysis-dependent). Cardiac computed tomography was performed to quantify coronary artery calcium score (CACS). Pressure-strain loop analysis was performed to obtain global and territorial work index (GWI and TWI, respectively). Logistic regression was applied to investigate the association between work measures and high CACS (>400).

Results

We included 455 patients (age: 57 years, 60% men, 8% with previous CAD, and eGFR of 43 mL/min/1.73 m²). High CACS across all coronary arteries was observed in 77 (17%), with 53 (12%) in the left anterior descending (LAD) artery, 28 (6%) in the right coronary artery (RCA), and 17 (4%) in the circumflex (Cx) artery.

No difference in GWI was observed for overall high versus non-high CACS (1861 vs. 1937 mmHg%, p = 0.14). TWI was reduced in patients with high versus non-high CACS in the LAD (1772 vs. 1956 mmHg%, p = 0.003) and in the Cx (1556 vs. 1934 mmHg%, p = 0.001), but not in the RCA (p = 0.68). After multivariable regression, TWI remained significantly associated with high CACS in the LAD and Cx in patients with no history of CAD, but not in the RCA.

Conclusion

In patients with CKD, GWI was not associated with an overall high CACS. TWI was, however, associated with a high CACS in specific coronary arteries, although the findings were inconsistent.

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慢性肾病患者心肌功与冠状动脉钙评分的关系

背景：心肌功是一种诊断冠状动脉疾病（CAD）的新方法。因此，它可能对慢性肾脏疾病（CKD）患者有用，在这些患者中，诊断工作可能具有挑战性。方法：这是一项CKD患者（G1-5，非透析依赖）的横断面研究。进行心脏计算机断层扫描，量化冠状动脉钙评分（CACS）。通过压力-应变环分析获得全局和区域工作指数（GWI和TWI）。采用Logistic回归研究工作措施与高CACS （bbb400）之间的关系。结果：我们纳入了455例患者（年龄：57岁，60%为男性，8%既往患有CAD， eGFR为43 mL/min/1.73 m2）。77例（17%）冠状动脉均出现高CACS，其中左前降支（LAD） 53例（12%），右冠状动脉（RCA） 28例（6%），旋支（Cx） 17例（4%）。总体高与非高CACS组GWI无差异（1861 vs 1937 mmHg%, p = 0.14）。在LAD （1772 vs. 1956 mmHg%, p = 0.003）和Cx （1556 vs. 1934 mmHg%, p = 0.001）的高CACS患者中，TWI减少（p = 0.68），但在RCA中没有（p = 0.68）。多变量回归后，TWI仍与无CAD病史的LAD和Cx患者的高CACS显著相关，但与RCA无关。结论：在CKD患者中，GWI与总体高CACS无关。然而，TWI与特定冠状动脉的高CACS有关，尽管研究结果不一致。

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

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.