Left Atrial Reservoir Strain by Speckle Tracking Echocardiography: Association With Exercise Capacity in Chronic Kidney Disease

Autor: Aditya Bhat, Karen Byth, Liza Thomas, S. Eshoo, Fernando Fernandez, Krishna K. Kadappu, Henry H.L. Chen, Gary C.H. Gan, Kennith H. Gu
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
030232 urology & nephrology
Left atrium
Strain (injury)
Speckle tracking echocardiography
030204 cardiovascular system & hematology
Left atrial strain
Severity of Illness Index
Imaging
left atrium
Body Mass Index
03 medical and health sciences
0302 clinical medicine
Left atrial
Cardiovascular Disease
Internal medicine
medicine
Humans
Heart Atria
Renal Insufficiency
Chronic
Correlation of Data
Original Research
exercise echocardiography
Exercise Tolerance
left atrial strain
business.industry
Middle Aged
Exercise capacity
medicine.disease
Exercise echocardiography
exercise capacity
medicine.anatomical_structure
Echocardiography
Cardiology
diastolic dysfunction
Atrial Function
Left
Female
Exercise Testing
Cardiology and Cardiovascular Medicine
business
chronic kidney disease
Glomerular Filtration Rate
Kidney disease
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
DOI: 10.1161/jaha.120.017840
Popis: Background Left atrial (LA) function plays a pivotal role in modulating left ventricular performance. The aim of our study was to evaluate the relationship between resting LA function by strain analysis and exercise capacity in patients with chronic kidney disease (CKD) and evaluate its utility compared with exercise E/e'. Methods and Results Consecutive patients with stage 3 and 4 CKD without prior cardiac history were prospectively recruited from outpatient nephrology clinics and underwent clinical evaluation and resting and exercise stress echocardiography. Resting echocardiographic parameters including E/e' and phasic LA strain (LA reservoir [LASr], conduit, and contractile strain) were measured and compared with exercise E/e'. A total of 218 (63.9±11.7 years, 64% men) patients with CKD were recruited. Independent clinical parameters associated with exercise capacity were age, estimated glomerular filtration rate, body mass index, and sex ( P P P P =0.20 on DeLong test). A model combining LASr and clinical metrics showed robust association with metabolic equivalents achieved in patients with CKD. Conclusions LASr, a marker of decreased LA compliance is an independent correlate of exercise capacity in patients with stage 3 and 4 CKD, with similar diagnostic value to exercise E/e'. Thus, LASr may serve as a resting biomarker of functional capacity in this population.
Databáze: OpenAIRE
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