Abstract 19070: Three-Dimensional Speckle Tracking-Derived Left Ventricular Myocardial Deformation in Children With End-Stage Renal Disease
Introduction: Detrimental effect of chronic renal replacement therapy on cardiac function is important in the management of children with end-stage renal disease (ESRD). Three-dimensional (3D) speckle tracking echocardiography (STE) is an emerging method to assess myocardial deformation and possibly more sensitive to detect subclinical myocardial dysfunction.
Hypothesis: We hypothesized that children with ESRD have reduced left ventricular (LV) myocardial deformation, assessed by 3D STE.
Methods: LV 3D volume data were prospectively collected in children with ESRD and on chronic renal replacement therapy (before / after hemodialysis and peritoneal dialysis) and in normal controls. LV 3D volume data were analyzed off-line by the Philips QLAB 10 and the TomTec 4D LV-Function software. The 3D LV volume, ejection fraction and global longitudinal strain (GLS) were compared between the groups. The data were compared by either independent sample t-test or paired t-test.
Results: The mean age of 27 children on dialysis (hemodialysis 14 and peritoneal dialysis 13) was 13.6 ± 3.8 years compared to 11.2 ± 3.6 years in 57 normal controls (p < 0.005), whereas there was no difference in weight and height between 2 groups. Whereas the 3D LV ejection fraction was comparable between the groups, LV end-diastolic volume index (ml/m2) was higher in dialysis group (p = 0.001). GLS was reduced in dialysis group compared to normal (-18.6 ± 2.2 vs. -15.4 ± 3.2%, p = 0.001). In the subgroup analysis, GLS significantly decreased following hemodialysis session (-16.3 ± 2.7 to -12.1 ± 2.7%, p < 0.001), though 3D ejection fraction did not change. GLS in peritoneal dialysis group (-14.6 ± 3.5%) was significantly lower than pre-hemodialysis but higher than post-hemodialysis group.
Conclusions: Children with ESRD had significantly reduced 3D STE-derived LV myocardial deformation. Acute fluid status change associated with hemodialysis had a detrimental effect on myocardial mechanics.
Author Disclosures: D. Kobayashi: None. S. Aggarwal: None.
- © 2016 by American Heart Association, Inc.