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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
06:34

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Published on: October 28, 2020

A longitudinal study of left ventricular function and structure from CKD to ESRD: the CRIC study

Nisha Bansal1, Martin Keane, Patrice Delafontaine

  • 1Division of Nephrology, University of California, San Francisco, 521 Parnassus Avenue, Box 0532, San Francisco, CA 94143, USA. nisha.bansal@ucsf.edu

Clinical Journal of the American Society of Nephrology : CJASN
|February 16, 2013
PubMed

Insights

Left ventricular mass index remained stable from chronic kidney disease (CKD) to end-stage renal disease (ESRD), but ejection fraction significantly decreased during this transition. This decline in heart function may increase cardiovascular risk in patients undergoing dialysis.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Abnormal left ventricular structure and function are linked to adverse outcomes in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD).
  • Understanding changes in left ventricular mass and ejection fraction during the CKD to ESRD transition is crucial for improving cardiac outcomes.

Purpose of the Study:

  • To investigate changes in left ventricular mass index and ejection fraction in patients transitioning from advanced CKD to ESRD.
  • To identify potential factors influencing cardiac remodeling and function during the progression of kidney disease.

Main Methods:

  • Longitudinal study of a subset of the Chronic Renal Insufficiency Cohort (CRIC) study participants.
  • Serial echocardiograms were performed in patients with advanced CKD (eGFR < 20 mL/min/1.73 m²) and after ESRD diagnosis (initiation of dialysis).
  • Data collected between 2003 and 2011.

Main Results:

  • 190 participants (44% female, 66% Black) completed serial echocardiograms.
  • No significant change in left ventricular mass index (LVMI) was observed between advanced CKD and ESRD (62.3 vs. 59.5 g/m²·⁷, P=0.10).
  • Ejection fraction significantly decreased from 53% to 50% (P=0.002) during the transition from advanced CKD to ESRD.

Conclusions:

  • Left ventricular mass index is relatively stable in advanced stages of CKD and into ESRD.
  • A significant decline in ejection fraction occurs during the transition from advanced CKD to ESRD.
  • The decrease in ejection fraction may contribute to increased cardiovascular disease and mortality risk in patients on dialysis.
Abstract

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