Subclinical markers of cardiovascular disease predict adverse outcomes in chronic kidney disease patients with normal left ventricular ejection fraction
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Published version
Author(s)
Type
Journal Article
Abstract
Emerging cardiovascular biomarkers, such as speckle tracking echocardiography (STE) and aortic pulse wave velocity (aPWV), have recently demonstrated the presence of subclinical left ventricular dysfunction and arterial stiffening in patients with chronic kidney disease (CKD) and no previous cardiovascular history. However, limited information exists on the prognostic impact of these biomarkers. We aimed to investigate whether STE and aPWV predict major adverse cardiac events (MACE) in this patient population. In this cohort study we prospectively analysed 106 CKD patients with no overt cardiovascular disease (CVD) and normal left ventricular ejection fraction. Cardiac deformation was measured using STE while aPWV was measured using arterial tonometry. The primary end-point was the composite of all-cause mortality, acute coronary syndrome, stable angina requiring revascularization (either using percutaneous coronary intervention or coronary artery bypass surgery), hospitalization for heart failure and stroke. Over a median follow up period of 49 months (interquartile range 11–63 months), 26 patients (24.5%) reached the primary endpoint. In a multivariable Cox hazards model, global longitudinal strain (GLS) (HR 1.12, 95% CI 1.02–1.29, p = 0.041) and aPWV (HR 1.31, 95% CI 1.05–1.41, p = 0.021) were significant, independent predictors of MACE. GLS and aPWV independently predict MACE in CKD patients with normal EF and no clinically overt CVD.
Date Issued
2017-01-24
Date Acceptance
2016-12-30
Citation
INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 2017, 33 (5), pp.687-698
ISSN
1569-5794
Publisher
SPRINGER
Start Page
687
End Page
698
Journal / Book Title
INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
Volume
33
Issue
5
Copyright Statement
© 2017 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000399243300012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Radiology, Nuclear Medicine & Medical Imaging
Cardiovascular System & Cardiology
Chronic kidney disease
Speckle tracking echocardiography
Aortic pulse wave velocity
Cardiovascular outcomes
SPECKLE-TRACKING ECHOCARDIOGRAPHY
PULSE-WAVE VELOCITY
GLOBAL LONGITUDINAL STRAIN
DIASTOLIC HEART-FAILURE
ALL-CAUSE MORTALITY
RENAL-FUNCTION DECLINE
ARTERIAL STIFFNESS
TISSUE DOPPLER
MYOCARDIAL-INFARCTION
EUROPEAN ASSOCIATION
Nuclear Medicine & Medical Imaging
1102 Cardiovascular Medicine And Haematology
Publication Status
Published