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Quantitative assessment of left ventricular myocardial work in chronic kidney disease patients by a novel non-invasive pressure–strain loop analysis method

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Abstract

This study aimed to quantitatively evaluate myocardial work (MW) in advanced stage 3–5 chronic kidney disease (CKD) by a novel non-invasive left ventricular (LV) Pressure–strain loop analysis (PSL). 144 patients with CKD were included (68 with stage 3 CKD group, 76 with stage 4/5 CKD group), and 48 healthy patients were recruited as the control group. All subjects had undergone transthoracic echocardiography. LV myocardial work and efficiency were estimated from LV PSL analysis. There was a significant progressive increase in global work waste (GWW) and reduction in global work efficiency (GWE) in CKD compared to normal controls. No difference in global work index (GWI) and global constructive work (GCW) was observed among the three groups. Subdivided analysis according to systolic blood pressure (SBP) and LV geometry discovered that increased GWW seems to be present frequently in CKD patients with elevated SBP or LV hypertrophy (LVH). Multivariate analysis showed increased peak strain dispersion (PSD), SBP, LV mass index (LVMI), and decreased estimated glomerular filtration rate (eGFR) were significantly associated with increased GWW. The decline of renal function followed by impaired paralleled myocardial energy exploitation. Moreover, increased PSD, SBP, LVMI, and decreased eGFR might be potential drivers of increased GWW.

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Funding

This study was supported by grants from the Key Science and Technology Research Project of the Department of Education, Jiangxi Province (Grant No. 19002); Postgraduate Innovation Special Fund project of Nanchang University (Grant No. CX 2019135).

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Authors and Affiliations

  1. Department of Ultrasound, the Second Affiliated Hospital of Nanchang University, No.1, Minde Road, Donghu District, Nanchang, 330006, Jiangxi, China

    Feng-Zhen Liu, Xiao-Lin Wang & Chun-Quan Zhang

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  1. Feng-Zhen Liu
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  2. Xiao-Lin Wang
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Correspondence to Chun-Quan Zhang.

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Liu, FZ., Wang, XL. & Zhang, CQ. Quantitative assessment of left ventricular myocardial work in chronic kidney disease patients by a novel non-invasive pressure–strain loop analysis method. Int J Cardiovasc Imaging 37, 1567–1575 (2021). https://doi.org/10.1007/s10554-020-02132-9

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