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Resting strain analysis to identify myocardial ischemia in patients with advanced chronic kidney disease
Dimitrios Tsartsalis1, Yannis Dimitroglou1, Argyro Kalompatsou1
1First Department of Cardiology, 'Hippokration' Hospital, University of Athens, Medical School, Athens, Greece.
Clinical Physiology and Functional Imaging
|February 5, 2024
Summary
Resting left ventricular deformation analysis can predict myocardial ischemia in end-stage kidney disease patients undergoing stress echocardiography. This technique may help identify patients who could benefit from coronary artery screening.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Background:
- Chronic kidney disease (CKD) significantly increases cardiovascular mortality risk.
- Screening for coronary artery disease in CKD patients with mild symptoms is challenging.
Purpose of the Study:
- To assess the added value of resting deformation analysis in predicting myocardial ischemia during dobutamine stress echocardiography (DSE) in end-stage CKD patients.
Main Methods:
- Sixty-one end-stage CKD patients underwent resting echocardiography and DSE.
- Left ventricular (LV) ejection fraction (EF), LV global longitudinal strain (GLS), and left atrial (LA) strain were measured.
- Positive DSE results were defined as stress-induced LV wall motion abnormalities.
Main Results:
- The cohort showed preserved LV systolic function (mean EF 49.2%) but impaired LA strain in half the patients.
- DSE was positive for ischemia in 55.7% of patients.
- LV GLS and LA conduit strain were negatively associated with DSE results, while LV and LA dimensions correlated positively with ischemia.
Conclusions:
- Resting LV deformation parameters, particularly GLS, independently predict positive DSE results in end-stage CKD.
- LV deformation analysis may aid in identifying CKD patients who warrant further coronary artery screening.
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