Cardiovascular Diseases Institute "Prof. Dr. George I.M. Georgescu", Iasi, Romania.
"Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
Echocardiography. 2021 Dec;38(12):2077-2082. doi: 10.1111/echo.15259. Epub 2021 Nov 24.
Cardiovascular disease and chronic kidney disease are frequently inter-connected and this association leads to an exponential growth of cardiovascular risk. This risk is currently underestimated by the existing algorithms and there is a constant need for new markers to predict adverse outcomes in this special population. In general population left atrial strain has emerged as an important tool for both the diagnosis and prognostic stratification, but data regarding its role in chronic kidney disease patients is scarce. The purpose of this review is to summarize the current evidence regarding this matter. Left atrial size and function mirror the duration and severity of increased left ventricular filling pressures. Increased left atrial volume index and impaired left atrial strain parameters are independent predictors for adverse cardiovascular events. Left atrial strain is impaired before changes in volume appear, thus being able to predict both diastolic and systolic function in chronic kidney disease patients. Finally, left atrial strain can identify renal patients with impaired exercise capacity and this could have clinical applications in the rehabilitation of this patients.
心血管疾病和慢性肾脏病经常相互关联，这种关联导致心血管风险呈指数级增长。这种风险目前被现有算法低估了，因此需要新的标志物来预测这一特殊人群的不良结局。在一般人群中，左心房应变已成为诊断和预后分层的重要工具，但关于其在慢性肾脏病患者中的作用的数据却很少。本综述的目的是总结这方面的现有证据。左心房的大小和功能反映了左心室充盈压升高的持续时间和严重程度。左心房容积指数增加和左心房应变参数受损是不良心血管事件的独立预测因素。左心房应变在容积发生变化之前就已经受损，因此能够预测慢性肾脏病患者的舒张和收缩功能。最后，左心房应变可以识别运动能力受损的肾脏患者，这在该患者的康复中可能具有临床应用价值。
