Global Longitudinal Strain of the Left Ventricle in Patients with Chronic Kidney Disease and Hemodialysis

Abstract

The impact of chronic kidney disease (CKD) and hemodialysis (HD) on heart function is not fully understood. Assess the influence of different grades of chronic nephropathy and HD on the cardiac function using myocardial deformation: Longitudinal global strain (LGS) Descriptive cross-sectional study conducted between January 2017 and January 2018, concerning patients followed for CKD sent for cardiac evaluation. The patients were classified into 3 subgroups (Control: without CKD; Medium to advanced CKD: stages 3, 4 or 5, and terminal CKD on HD. The systolic function of the LV was evaluated by echocardiography with the analysis of the LGS. The study included 100 patients, According to the subgroups: 33 did not have CKD (control), 27 had moderate to advanced CKD (stages 3, 4 or 5) and 40 had terminal CKD on HD. There was no significant difference in gender, age and LVEF among the groups. Compared to control group, the absolute value of SLG was decreased in the CKD groups, this decrease is parallel to the decline in renal function. In addition, compared to moderate CKD patients, LV systolic function was better in patients with CKD on HD. Myocardial strain analysis is much more sensitive for predicting and detecting LV systolic dysfunction in patients with CKD. The decline in kidney function parallels the deterioration in heart function which may indicate that toxins play an important role in LV dysfunction, HD helps clarify toxins and improve LV function.