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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Myocardial Work and Cardiovascular Events in Patients With Chronic Kidney Disease
Flemming Javier Olsen1,2, Nino Emanuel Landler1,2, Jacob Christensen1,2
1Cardiovascular Non-Invasive Imaging Research Laboratory, Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Hellerup, Denmark.
Echocardiography (Mount Kisco, N.Y.)
|October 17, 2025
Summary
In patients with chronic kidney disease (CKD), abnormal myocardial work indices, specifically wasted work (GWW) and work efficiency (GWE), are linked to major adverse cardiovascular events (MACE), primarily heart failure (HF).
Area of Science:
- Cardiology
- Nephrology
- Echocardiography
Background:
- Patients with chronic kidney disease (CKD) face elevated risks of cardiovascular (CV) events.
- Myocardial work indices offer novel echocardiographic insights into left ventricular (LV) function abnormalities.
Purpose of the Study:
- To investigate the association between myocardial work indices and major adverse cardiovascular events (MACE) in patients with CKD.
- To determine if specific indices like global work index (GWI), constructive work (GCW), wasted work (GWW), and work efficiency (GWE) predict MACE.
Main Methods:
- Prospective echocardiography with pressure-strain loop analysis to measure myocardial work indices in CKD patients.
- Cox regression and competing risk regression analyses were used to assess the association between myocardial work indices and MACE, accounting for all-cause death.
Main Results:
- Of 697 CKD patients, 42 (6%) experienced MACE during follow-up.
- Initially, all myocardial work indices correlated with MACE. Post-adjustment, GCW, GWW, and GWE remained associated.
- In competing risk regression, only GWW and GWE showed significant association with MACE, primarily driven by heart failure (HF) rather than ischemic heart disease.
Conclusions:
- Wasted work (GWW) and work efficiency (GWE) are independent predictors of MACE in non-dialysis dependent CKD patients.
- The association of these myocardial work indices with MACE is predominantly linked to heart failure development.
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