Volume : V, Issue : XI, November - 2016

Asymptomatic LV Dysfunction in patients of Chronic Kidney Disease on Maintenance Hemodialysis

Dr Hetan C Shah, Dr. Charan P. Lanjewar, Dr Akshay Bafna, Dr. Prafulla G. Kerkar

Abstract :

 Aims : To identify subclinical left ventricular (LV) myocardial dysfunction using speckle tracking echocardiography (STE) in patients with chronic kidney disease (CKD), preserved LV ejection fraction (LVEF), and no cardiovascular history or symptoms. Methods : 73 patients satisfying the inclusion criteria were recruited in this cross sectional Exploration study. ?eir Ecocardiography (ECHO) was done taking both conventional 2D ECHO parameters and LV strain imaging parameters using Speckle Tracking Imaging(STE)on GE Vivid T8 Echo Machine in KEM Hospital, Mumbai. Results: Global longitudinal systolic strain was the most important parameter to be studied. Values of GLS were least among the CKD stage 5D group and were statistically significant.GLS in CKD 5D was –9.1±2.01. ?is differed significantly from control group (p valuem<0.005). .Global longitudinal strain rate at the end of diastole was 1.04±0.33 in CKD 5D. ?is was significantly less as compared with the controls.(p value0.005)..LVMI was 75±22.3 for CKD 4/5 and 120±25.2 for CKD 5D due to chronic long standing hypertension which increased the LV mass. ?is also correlates with percentage of patients with left ventricular hypertrophy. Along with significant diastolic dysfunction.Grade 3.Even ?e number of segments with diastolic dysfunction were more in the CKD groups compared with controls.( p value<0.005). Patients who received more number of dialysis had lower values of GLS indicating such patients had significant asymptomatic LV dysfunction. Conclusion: In this cohort of patients with advanced CKD, GLS is a more sensitive predictor of overall and CV mortality compared to EF. Studies of larger populations in CKD are required to confirm that GLS provides additive prognostic value in patients with preserved EF

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Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

Dr Hetan C Shah, Dr. Charan P. Lanjewar, Dr Akshay Bafna, Dr. Prafulla G.Kerkar, Asymptomatic LV Dysfunction in patients of Chronic Kidney Disease on Maintenance Hemodialysis, International Journal of Scientific Research, Volume : 5 | Issue : 11 | November 2016

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