Echocardiographic Assessment of Left Ventricular Systolic Dysfunction in Chronic Kidney Disease Patients of a Rural Tertiary Medical Care Centre in West Bengal

Abstract

Objective: To evaluate the prevalence of LV systolic dysfunction in patients with CKD (Hemodialysis naive patients) & assess the severity of dysfunction in respect to stages of CKD. Methodology: This is a cross sectional study conducted at the Medicine Department, B.S. Medical College, West Bengal during the period of one year from 1st May 2012 to 30th April 2013. 50 patients of both sexes and ages above 18 years and below 65 years presenting with chronic kidney disease who did not underwent dialysis, were included in the study. A proforma was designed to collect data containing basic information, history & physical examination and the relevant hematological, biochemical and radiological investigations like Electrocardiography and Echocardiography (2D & M mode). Based on the eGFR value (by Cockroft-Gault equation), Patients were divided in two categories - mild/moderate Chronic Kidney Disease [those with eGFR >30ml/min/1.73m 2 = CKD stages 1-3] (N = 27) and severe Chronic Kidney Disease [those with eGFR <30ml/min/1.73m 2 =CKD stages 4 - 5] (N = 23). And echocardiographic LV systolic parameters were analysed and compared between the two groups. Result: 15% of mild/moderate CKD patients showed low EF & 48% of severe CKD had evidence of low EF. 22% patients with mild/moderate CKD, and 26% with severe CKD had impaired fractional shortening. LVH was 58% among total study population, & it was 33% and 87% among two groups. Among all LVH, 31% was concentric and 69% was eccentric type. Conclusion: Chronic Kidney Disease patients has higher prevalence of left ventricular hypertrophy (LVH) and higher prevalence of systolic dysfunction, which was more pronounced in CKD stage 4-5.