Key result
Chronic kidney disease was associated with a significantly higher prevalence of left ventricular systolic asynchrony compared to controls (44% vs 12%, P=0.01).
Why the study?
Is left ventricular systolic asynchrony present in patients with chronic kidney disease and normal QRS duration compared to control subjects?
Case-Control (n=50)
Is left ventricular systolic asynchrony present in patients with chronic kidney disease and normal QRS duration compared to control subjects?
Patients with chronic kidney disease and narrow QRS complexes exhibit significant left ventricular systolic asynchrony compared to healthy controls, which correlates with LV structural and functional parameters.
LV asynchrony assessment should not yet change CKD practice; leaves open its prognostic value and therapeutic implications.
OBJECTIVE: The evidence of structural and functional cardiac abnormalities has been demonstrated by echocardiography in patients with chronic kidney disease (CKD). This study investigated whether left ventricular (LV) asynchrony is present in patients with CKD and normal QRS duration. METHODS: Tissue synchronization imaging (TSI) was performed in 25 (56 +/- 14 years) patients with CKD and narrow QRS complexes and 25 (51 +/- 12 years) control subjects. LV asynchrony was identified on TSI images and the time to regional peak systolic velocity (Ts) in LV was measured by the six-basal-six-midsegmental model. Four TSI parameters of systolic asynchrony were computed when Ts was measured in ejection phase. RESULTS: The standard deviation of Ts of 12 LV segments (33.6 +/- 17.8 vs 16.7 +/- 10 ms, P = 0.0001), standard deviation of Ts of the six basal LV segments (30 +/- 20 vs 17.6 +/- 9.6 ms, P = 0.008), maximal difference in Ts between any two of the 12 LV segments (102 +/- 45 vs 54 +/- 32 ms, P = 0.0001), and maximal difference in Ts between any two of the six basal LV segments (78 +/- 50 vs 46 +/- 22 ms, P = 0.007) were prolonged in patients with CKD compared with controls. The prevalence of LV systolic asynchrony was significantly higher in patients with CKD compared with controls (44% vs 12%, P = 0.01). The standard deviation of Ts of 12 LV segments were significantly associated with LV diameters, LV volumes, LV mass, blood pressure levels, and renal functions in univariate analysis. CONCLUSION: The results of this study indicate that LV systolic asynchrony may develop in patients with CKD.
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Gedikli et al. (2009) conducted a case-control in Chronic kidney disease with narrow QRS complexes (n=50). Chronic kidney disease vs. Control subjects was evaluated on Prevalence of left ventricular systolic asynchrony (p=0.01). Chronic kidney disease was associated with a significantly higher prevalence of left ventricular systolic asynchrony compared to controls (44% vs 12%, P=0.01).
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