Impact of early chronic kidney disease on left atrial function and volume

Background: Chronic kidney disease (CKD) is one of the most important factors affecting cardiovascular morbidity and mortality. Left atrial (LA) volume indexed (LAVI) for body surface area is the most accurate measure of LA size that was obtained by standard echocardiography. The aim of this study was to investigate the value of strain analysis and LA volume in the detection of myocardial involvement in early CKD. Methods: The study included 60 patients divided into two groups: Group I: patients with early CKD (estimated glomerular filtration rate >30 ml/min/1.73 m2) without any previous cardiac illness and Group II: healthy age-matched controls with normal renal function. Echocardiographic examinations including LAVI and LA strain were measured in all participants. Results: LA wall systolic strain values decreased in the CKD group compared to the healthy control group (16.23% ± 6.33% vs. 38.84% ± 9.37%, P < 0.0001, on the lateral wall; 14.16% ± 3.64% vs. 26.66% ± 9.75%, P < 0.0001, on the septal wall; 17.23% ± 8.41% vs. 32.23% ± 7.92%, P < 0.0001, on the anterior wall; and 19.65% ± 7.58% vs. 47.48%–11.24%, P < 0.0001, on the inferior wall). LA systolic strain was more reduced in Stage 3 CKD than Stages 1 and 2. LAVI was significantly larger in the CKD group compared to healthy controls (36.20 ± 8.21 vs. 22.18 ± 3.00 ml/m2, P < 0.0001). Conclusion: LA function evaluated by strain is reduced and LA volume is increased in the early stages of CKD, and Stage 3 CKD is the most affected stage.