Abstract
Cardiovascular abnormalities are observed in most children with end-stage renal disease (ESRD). The aim of this study was evaluation of left-ventricular (LV) myocardial performance using tissue-Doppler imaging (TDI) in patients with ESRD. Twenty-five patients with ESRD and 25 healthy gender- and age-matched control subjects were assessed with conventional M-mode echocardiography, pulsed-wave Doppler (PWD), and TDI. Myocardial Performance Index (MPI) and LV mass index (LVMI) were calculated. MPI and conventional echo-Doppler indices were compared in the ESRD and control groups. Significant differences were present in the mean systolic and diastolic blood pressure (BP) between children with ESRD and healthy children (p = 0.007 and p < 0.001, respectively). The mean LVMI was significantly greater in the patient group (p < 0.001). The tissue-Doppler MPI of patients was significantly higher than that in healthy children (p < 0.001). LVMI was significantly correlated with systolic and diastolic BP. MPI obtained by TDI was significantly correlated with LVMI. Our study confirms that LV dysfunction is present in patients with ESRD and hypertension is an important risk factor.
Similar content being viewed by others
References
Johnstone LM, Jones CL, Grigg LE, Wilkinson JL, Walker RG, Powell HR (1996) Left ventricular abnormalities in children, adolescents and young adults with renal disease. Kidney Int 50:998–1006
Atalay S, Ekim M, Tutar E, Koçak G, Bakkaloğlu S, Tümer N (2002) Systolic and diastolic function in children with chronic renal failure. Pediatr Int 44:18–23
Dyadyk OI, Bagriy AE, Yarovaya NF (1999) Disorders of left ventricular structure and function in chronic uremia. How often, why and what to do with it? Eur J Heart Fail 1:327–336
Gruppen MP, Groothoff JW, Prins M, van der Wouw P, Offringa M, Bos WJ, Davin JC, Heymans HS (2003) Cardiac disease in young adult patients with end stage renal disease since childhood: A Dutch cohort study. Kidney Int 63:1058–1065
Mitsnefes MM, Daniels SR, Schwartz SM, Meyer RA, Khoury P, Strife CF (2000) Severe left ventricular hypertrophy in pediatric dialysis: prevalence and predictors. Pediatr Nephrol 14:898–902
Tei C, Nishimura RA, Seward JB, Tajik AJ (1997) Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr 10:169–178
Tei C, Dujardin KS, Hodge DO, Kyle RA, Tajik AJ, Seward JB (1996) Doppler index combining systolic and diastolic myocardial performance: clinical value in cardiac amyloidosis. J Am Coll Cardiol 28:658–664
Dujardin KS, Tei C, Yeo TC, Hodge DO, Rossi A, Seward JB (1998) Prognostic value of a Doppler index combining systolic and diastolic performance in idiopathic-dilated cardiomyopathy. Am J Cardiol 82:1071–1076
Poulsen SH, Jensen SE, Nielsen JC, Moller JE, Egstrup K (2000) Serial changes and prognostic implications of a Doppler derived index of combined left ventricular systolic and diastolic performance in acute myocardial performance in acute myocardial infarction. Am J Cardiol 85:19–25
Ocal B, Oguz D, Karademir S, Birgen D, Yuksek N, Ertem U, Cabuk F (2002) Myocardial performance index combining systolic and diastolic myocardial performance in doxorubicin-treated patients and its correlation to conventional echo/Doppler indices. Pediatr Cardiol 23:522–527
Harada K, Tamura M, Toyono M, Oyama K, Takada G (2001) Assessment of global left ventricular function by tissue Doppler imaging. Am J Cardiol 88:927–932
Harada K, Tamura M, Toyono M, Yasuoka K (2002) Comparison of the right ventricular Tei index by tissue Doppler imaging to that obtained by pulsed Doppler in children without heart disease. Am J Cardiol 90:566–569
Devereux RB, Reichec N (1977) Echocardiographic determination of left ventricular mass in man: anatomic validation of the method. Circulation 55:613–618
Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 57:450–458
Matteucci MC, Wuhl E, Picca S, Mastrostefano A, Rinelli G, Romano C, Rizzoni G, Mehls O, de Simone G, Schaefer F (2006) Left ventricular geometry in children with mild to moderate chronic renal insufficiency. J Am Soc Nephrol 17:218–226
Daniels SR, Loggie JMH, Khoury P, Kimball TR (1998) Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 97:1907–1911
Tumer N, Yalcinkaya F, Ince E, Ekim M, Kose K, Cakar N, Kara N, Ozkaya N, Ensari C, Onder S (1999) Blood pressure nomograms for children and adolescents in Turkey. Pediatr Nephrol 13:438–443
Saygılı A, Yıldırım SV, Cengız N, Uslu Y, Tokel K, Saatci Ü (2005) Assessment of left ventricular diastolic function by Doppler tissue imaging in children with end-stage renal disease. Acta Paediatr 94:1055–1059
Hayashi SY, Rohani M, Lindholm B, Brodin LA, Lind B, Barany P, Alvestrand A, Seeberger A (2006) Left ventricular function in patients with chronic kidney disease evaluated by color tissue Doppler velocity imaging. Nephrol Dial Transplant 21:125–132
Mitsnefes MM, Barletta GM, Dresner IG, Chand DH, Geary D, Lin JJ, Patel H (2006) Severe cardiac hypertrophy and long-term dialysis: the Midwest Pediatric Nephrology Consortium study. Pediatr Nephrol 21:1167–1170
Civilibal M, Caliskan S, Oflaz H, Sever L, Candan C, Canpolat N, Kasapcopur O, Bugra Z, Arisoy N (2007) Traditional and “new” cardiovascular risk markers and factors in pediatric dialysis patients. Pediatr Nephrol 22:1021–1029
Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, Rodeheffer RJ, Tajik AJ, Seward JB (1995) New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function-a study in normals and dilated cardiomyopathy. J Cardiol 26:357–366
Tei C, Dujardin KS, Hodge DO, Bailey KR, McGoon MD, Tajik AJ, Seward SB (1996) Doppler echocardiographic index for assessment of global right ventricular function. J Am Soc Echocardiogr 9:838–847
Rojo EC, Rodrigo JL, Pérez de Isla L, Almería C, Gonzalo N, Aubele A, Cinza R, Zamorano J, Macaya C (2006) Disagreement between tissue Doppler imaging and conventional pulsed wave Doppler in the measurement of myocardial performance index. Eur J Echocardiogr 7:356–364
Harada K, Takahashi Y, Shiota T, Suzuki T, Tamura M, Ito T, Takada G (1995) Effect of heart rate on left ventricular diastolic filling patterns assessed by Doppler echocardiography in normal infants. Am J Cardiol 76:634–636
Yasuoka K, Harada K, Toyono M, Tamura M, Yamamoto F (2004) Tei Index Determined by Tissue Doppler Imaging in Patients with Pulmonary Regurgitation After Repair of Tetralogy of Fallot. Pediatr Cardiol 25:131–136
Ozdemir K, Balci S, Duzenli MA, Can I, Yazici M, Aygul N, Altunkeser BB, Altintepe L, Turk S (2007) Effect of Preload and Heart Rate on the Doppler and Tissue Doppler-Derived Myocardial Performance Index. Clin Cardiol 30:342–348
Su Y, Wu N, Tian J (2006) Evaluation of Cardiac Global Function Using the Myocardial Performance Index by Tissue Doppler Echocardiography in Patients With Uremia. J Ultrasound Med 25:1563–1569
Chinali M, de Simone G, Matteucci MC, Picca S, Mastrostefano A, Anarat A, Caliskan S, Jeck N, Neuhaus TJ, Peco-Antic A, Peruzzi L, Testa S, Mehls O, Wühl E, Schaefer F; ESCAPE Trial Group (2007) Reduced systolic myocardial function in children with chronic renal insufficiency. J Am Soc Nephrol 18:593–598
Mitsnefes MM, Kimball TR, Witt SA, Glascock BJ, Khoury PR, Daniels SR (2003) Left ventricular mass and systolic performance in pediatric patients with chronic renal failure. Circulation 107:864–868
de Simone G, Devereux RB, Daniels SR, Koren MJ, Meyer RA, Laragh JH (1995) Effect of growth on variability of left ventricular mass: Assessment of allometric signals in adults and children and their capacity to predict cardiovascular risk. J Am Coll Cardiol 25:1056–1062
Mitsnefes MM, Kimball TR, Border WL, Witt SA, Glascock BJ, Khoury PR, Daniels SR (2004) Impaired left ventricular diastolic function in children with chronic renal failure. Kidney Int 65:1461–1466
Mitsnefes MM, Kimball TR, Border WL, Witt SA, Glascock BJ, Khoury PR, Daniels SR (2004) Abnormal cardiac function in children after renal transplantation. Am J Kidney Dis 43:721–726
Hernandez D, Lacalzada J, Salido E, Linares J, Barragán A, Lorenzo V, Higueras L, Martín B, Rodríguez A, Laynez I, González-Posada JM, Torres A (2000) Regression of left ventricular hypertrophy by lisinopril after renal transplantation: Role of ACE gene polymorphism. Kidney Int 58:889–897
Klein IH, Ligtenberg G, Oey PL, Koomans HA, Blankestijn PJ (2003) Enapril and losartan reduce sympathetic hyperactivity in patients with chronic renal failure. J Am Soc Nephrol 14:425–430
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Uçar, T., Tutar, E., Yalçınkaya, F. et al. Global left-ventricular function by tissue Doppler imaging in pediatric dialysis patients. Pediatr Nephrol 23, 779–785 (2008). https://doi.org/10.1007/s00467-007-0734-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-007-0734-5