Kizilca Ozgur, Ozmen Derya, Demircan Tulay, Yilmaz Nuh, Kir Mustafa, Soylu Alper, Unal Nurettin, Kavukcu Salih
Department of Pediatric Cardiology, Medical Faculty of Dokuz Eylul University, Izmir, Turkey.
Department of Pediatric Nephrology, Medical Faculty of Dokuz Eylul University, Izmir, Turkey.
Cardiol Young. 2021 Mar;31(3):421-428. doi: 10.1017/S1047951120004205. Epub 2020 Dec 14.
Chronic kidney disease may lead to left ventricular dysfunction. Early detection of cardiovascular disease in children with chronic kidney disease is essential to prevent cardiovascular morbidity and mortality in early adulthood. This study aimed to document the dysfunction using methods such as two-dimensional speckle-tracking echocardiography in the early stage.
A total of 34 patients diagnosed with chronic kidney disease (mean age ± standard deviation, 10.5 ± 4.1 years) and 37 sex- and age-matched (mean age 9.8 ± 4.2 years) healthy controls were studied. The results of the two groups were compared along with those of the published studies.
The echocardiography measurements had no significant difference in the end-diastolic and end-systolic diameter values of left ventricular, ejection fraction, shortening fraction, mitral E value, mitral A value, and E/A ratio between the groups. Pulmonary artery systolic and diastolic pressure and left ventricular mass index were significantly higher in the patient group (p < 0.01). The longitudinal global strain values in the apical four-chamber, three-chamber, and two-chamber views and the total global strain values were significantly lower in the patients (p < 0.01). The circumferential global strain values in the apical, mid, basal, and total global strain were lower in the patient group, but this difference was statistically significant in the apical global and total global strain values (p < 0.05).
Speckle-tracking echocardiography might help identify subclinical left ventricular dysfunction in patients with chronic kidney disease with unremarkable conventional echocardiography.
慢性肾脏病可能导致左心室功能障碍。早期发现慢性肾脏病患儿的心血管疾病对于预防成年早期的心血管发病率和死亡率至关重要。本研究旨在早期使用二维斑点追踪超声心动图等方法记录功能障碍情况。
共研究了34例诊断为慢性肾脏病的患者（平均年龄±标准差，10.5±4.1岁）和37例性别与年龄匹配（平均年龄9.8±4.2岁）的健康对照者。将两组结果与已发表研究的结果进行比较。
两组之间左心室舒张末期和收缩末期直径值、射血分数、缩短分数、二尖瓣E值、二尖瓣A值以及E/A比值的超声心动图测量结果无显著差异。患者组的肺动脉收缩压和舒张压以及左心室质量指数显著更高（p<0.01）。患者的心尖四腔心、三腔心和两腔心视图中的纵向整体应变值以及总整体应变值显著更低（p<0.01）。患者组的心尖、中间、基底和总整体应变中的圆周整体应变值较低，但心尖整体和总整体应变值的这种差异具有统计学意义（p<0.05）。
斑点追踪超声心动图可能有助于识别常规超声心动图无异常的慢性肾脏病患者的亚临床左心室功能障碍。
