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Evaluation of left atrial functions in children with chronic renal failure
Savaş Demirpençe1, Barış Güven, Timur Meşe
1Clinic of Pediatric Cardiology, İzmir Buca Gynecology and Obstetrics and Pediatric Diseases Hospital; İzmir-Turkey. savasdemirpence@yahoo.com.
Insights
Evaluating left atrial function in children with chronic renal failure can help detect diastolic dysfunction. Left atrial systolic force and volume assessments are useful for determining the need for dialysis in these patients.
Area of Science:
- Pediatric Nephrology
- Cardiology
- Echocardiography
Background:
- Cardiovascular complications cause a quarter of deaths in children with chronic renal failure.
- Conventional echocardiography has limitations in assessing systolic function in pediatric chronic renal failure.
Purpose of the Study:
- To investigate cardiac function in children with chronic renal failure.
- To evaluate left atrial volume and function as indicators of cardiac health.
Main Methods:
- Cross-sectional observational study of 44 children on dialysis, 16 with chronic renal failure not on dialysis, and 20 healthy controls.
- Transthoracic echocardiography used to measure left atrial and ventricular parameters.
- Key measurements included left atrial systolic force, left atrial volume, and left ventricular mass index.
Main Results:
- Left atrial systolic force index showed negative correlation with systolic blood pressure and left ventricular mass.
- Positive correlation observed between left atrial systolic force index and early/late diastolic mitral inflow velocity.
- No significant group differences in left atrial systolic force index or volume, but higher index in children with chronic renal failure not yet on dialysis.
Conclusions:
- Left atrial systolic force is linked to blood pressure and left ventricular mass.
- Assessing left atrial systolic force and volume aids in identifying diastolic dysfunction.
- These evaluations may help determine the necessity of dialysis in pediatric chronic renal failure patients.
Objective:
One-quarter of deaths in children with chronic renal failure is due to cardiovascular complications. Conventional echocardiographic methods are insufficient for evaluating systolic functions in children with chronic renal failure. The aim of the present study was to investigate cardiac functions in children with chronic renal failure by evaluating left atrial volume and functions.
Methods:
The present cross-sectional observational study included 44 children undergoing dialysis, 16 children with chronic renal failure but not yet on dialysis, and 20 healthy control subjects. Transthoracic echocardiography was performed for all children. Variables regarding to left ventricle and atrium (left atrial systolic force, left atrial systolic force index, left atrial volume, left ventricular mass index, and relative wall thickness) were measured using two-dimensional and M-mode echocardiography.
Results:
Left atrial systolic force index was negatively correlated with systolic blood pressure and left ventricular mass (p=0.01, r=0.266 and p=0.02, r=0.347, respectively). However, it was positively correlated with both early and late diastolic mitral inflow velocity (r=0.518, p=0.001 and r=0.828, p=0.001, respectively). There were no significant difference among the groups in terms of left atrial systolic force index and left atrial volume. However, left atrial systolic force index was higher in children with chronic renal failure but not yet on dialysis.
Conclusion:
Left atrial systolic force was negatively correlated with systolic blood pressure and left ventricular mass. These findings suggested that evaluating left atrial systolic force and left atrial volume were useful to determine diastolic dysfunction and the necessity of dialysis in patient with chronic renal failure.
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