Assessments of left ventricular systolic and diastolic functions with tissue Doppler imaging and myocardial performance index in children with chronic kidney disease

• Published in: Pediatrics international Vol. 63; no. 12; pp. 1483 - 1489
• Main Authors: Kizilca, Ozgur, Ozmen, Derya, Bahaettin Öncü, Seyyit, Zihni, Cuneyt, Kir, Mustafa, Soylu, Alper, Unal, Nurettin, Kavukcu, Salih
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01-12-2021
• Subjects: Adolescent; Blood pressure; Child; Child, Preschool; Children; chronic kidney disease; Diastole; Doppler effect; Glomerular filtration rate; Heart; Heart Ventricles; Humans; Kidney diseases; myocardial performance index; Patients; Pediatrics; Pulmonary arteries; Pulmonary artery; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - diagnostic imaging; Systole; tissue Doppler imaging; Ventricle; ventricular dysfunction; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - etiology; Ventricular Function, Left; chronic kidney disease; ventricular dysfunction; myocardial performance index; tissue Doppler imaging
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.14705

Background
This study aimed to document early left ventricular (LV) dysfunction in chronic kidney disease (CKD) using methods such as tissue Doppler imaging and the myocardial performance index (MPI).
Methods
A total of 40 patients diagnosed with CKD (mean age, 10.1 ± 4.1 years) and 40 sex‐ and age‐matched healthy controls (mean age, 9.6 ± 4.3 years) were examined. In the patient group, 20 patients had early stage (Stage 2–3) CKD and 20 patients had late‐stage (stage 4–5) CKD, and 18 patients had hypertension.
Results
The pulmonary artery systolic pressure (PAPs) and LV mass index (LVMI) were significantly higher in the patient group (P < 0.05). The LV septal and lateral margins of the mitral annulus E'/A' ratio, E/E' ratio and MPI results were significantly different between the groups (P < 0.05). The MPI scores were higher in late‐stage CKD than in early stage CKD (P < 0.05). The E'/A' ratio was lower and the MPI was higher in the hypertensive CKD group compared with the normotensive CKD group (P < 0.05). The E/E' ratio was correlated positively with the LVMI, and the PAPs, and negatively with glomerular filtration rate, S' value, E'/A' ratio. The MPI was correlated positively with blood pressure, LVMI, PAPs, and the S value, and negatively with the E'/A' ratio.
Conclusions
The E'/A' ratio, the E/E' ratio, and the isovolumetric relaxation time measured by tissue Doppler imaging is highly accurate and easily applicable for detecting diastolic LV function, and the MPI is suitable for detecting both systolic and diastolic LV dysfunction. Their routine use may be useful in evaluating LV functions in children with CKD.