Related Experiment Video

Updated: Jun 6, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Evaluation of combined left ventricular function using the myocardial performance index in children with chronic

Roya Isa Tafreshi1, Nakisa Human, Hasan Otukesh

  • 1Department of Pediatric Cardiology, Iran University of Medical Sciences, Aliasghar Children's Hospital, Tehran, Iran. tafreshi@iums.ac.ir

Echocardiography (Mount Kisco, N.Y.)
|December 9, 2010
PubMed

Insights

Myocardial performance index (MPI) measured by pulsed-wave Doppler (PWD) and tissue Doppler imaging (TDI) effectively detects early left ventricular dysfunction in children with chronic kidney disease (CKD). TDI-MPI offers superior predictive discrimination compared to PWD-MPI.

Area of Science:

  • Pediatric Cardiology
  • Nephrology
  • Echocardiography

Background:

  • Myocardial dysfunction in early chronic kidney disease (CKD) stages 2-4 is not well-characterized in pediatric populations.
  • Early detection of global left ventricular (LV) dysfunction is crucial for managing pediatric CKD patients.

Purpose of the Study:

  • To assess the clinical usefulness of myocardial performance index (MPI) via pulsed-wave Doppler (PWD-MPI) in predicting early LV function disturbances in children with CKD.
  • To evaluate the utility of tissue Doppler imaging (TDI) for calculating MPI (TDI-MPI) and compare it with the conventional PWD method.

Main Methods:

  • Echocardiography performed on 34 children (3-18 years) with CKD stages 2-4 and 35 age-matched healthy controls.
  • PWD-MPI calculated from mitral inflow and LV outflow Doppler spectra.
  • TDI-MPI calculated using time intervals measured from the mitral annulus.

Main Results:

  • Both PWD-MPI and TDI-MPI values were significantly different in pediatric CKD patients compared to controls.
  • TDI-MPI demonstrated superior predictive discrimination for identifying myocardial dysfunction versus PWD-MPI.
  • TDI-MPI (cutoff >0.34) showed 91% sensitivity and 82% specificity for LV dysfunction, while PWD-MPI (cutoff >0.36) had 64.7% sensitivity and 97% specificity.

Conclusions:

  • Subtle left ventricular function abnormalities are present early in pediatric patients with mild to moderate renal insufficiency.
  • Both PWD-MPI and TDI-MPI are appropriate indicators of global LV function in young patients with CKD.
  • TDI-MPI is a more sensitive tool for identifying LV dysfunction in this population.
Abstract

More Related Videos

Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice12:12

Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice

Published on: February 14, 2017

Evaluation of Right Ventricular Function in Experimental Models of Pulmonary Arterial Hypertension10:03

Evaluation of Right Ventricular Function in Experimental Models of Pulmonary Arterial Hypertension

Published on: June 27, 2025

Related Concept Videos

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...