Abstract
BackgroundLeft ventricular dysfunction is an important co-morbidity of end-stage renal disease (ESRD) and is associated with a poor prognosis in the adult population. In pediatric ESRD, left ventricular function is generally well preserved, but limited information is available on early changes in myocardial function. The aim of this study was to investigate myocardial mechanics in pediatric patients with ESRD using speckle-tracking echocardiography (STE).MethodsEchocardiographic studies, including M-mode, tissue Doppler imaging (TDI) and STE, were performed in 19 children on dialysis, 17 transplant patients and 33 age-matched controls. Strain measurements were performed from the apical four-chamber and the short axis view, respectively.ResultsThe interventricular and left ventricular posterior wall thickness was significantly increased in dialysis and transplant patients compared to healthy controls. No significant differences were found in shortening fraction, ejection fraction and systolic tissue Doppler velocities. Dialysis and transplant patients had a decreased mean longitudinal strain compared to healthy controls, with a mean difference of 3.1 [95 % confidence interval (CI) 2.0–4.4] and 2.7 (95 % CI 1.2–4.2), respectively. No differences were found for radial and circumferential strain.ConclusionsSpeckle-tracking echocardiography may reveal early myocardial dysfunction in the absence of systolic dysfunction measured by conventional ultrasound or TDI in children with ESRD.
Highlights
Cardiovascular disease is highly prevalent in children and adults with end-stage renal disease (ESRD) and has beenPediatr Nephrol (2016) 31:1499–1508 shown to be one of the main causes of mortality [1,2,3,4]
Children with a congenital heart disease were excluded. These three centers are involved in the Renal Insufficiency therapy in Children–Quality assessment and improvement (RICH-Q) project, in which all Dutch and Belgian centers providing pediatric renal replacement therapy (RRT) collaborate to improve the quality of care [22]
We assessed prevalence of hypertension in the patients, with hypertension defined as a blood pressure (BP) measurement of >95th percentile on at least three occasions based on gender, age and height according to the Fourth Report on the Diagnosis, Evaluation, and treatment of High Blood Pressure in Children and Adolescents [23], irrespective of use of antihypertensives
Summary
Cardiovascular disease is highly prevalent in children and adults with end-stage renal disease (ESRD) and has beenPediatr Nephrol (2016) 31:1499–1508 shown to be one of the main causes of mortality [1,2,3,4]. In children with ESRD, systolic LV function generally seems to be well preserved, as described in observational studies using twodimensional (2D) echocardiography and tissue Doppler measurements [7, 11]. Newer echocardiographic techniques, such as speckletracking echocardiography (STE), allow the study of myocardial deformation and myocardial mechanics [12,13,14]. The aim of the study reported here was to identify early changes in myocardial mechanics in pediatric patients with ESRD using STE as the imaging modality. Strain measurements were performed from the apical four-chamber and the short axis view, respectively
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
