Key result
Increased aortic stiffness was independently associated with higher left ventricular twist (β = 0.163, p = 0.025) in asymptomatic patients with chronic kidney disease.
Why the study?
Does aortic stiffness correlate with left ventricular twist in asymptomatic patients with chronic kidney disease?
Observational (n=106)
No
Does aortic stiffness correlate with left ventricular twist in asymptomatic patients with chronic kidney disease?
Effect estimate: β = 0.163
Absolute Event Rate: 23.5% vs 19.8%
p-value: p=0.025
Aortic stiffness is independently associated with increased left ventricular twist in asymptomatic patients with chronic kidney disease, suggesting an early interplay between arterial and ventricular mechanics.
Aortic stiffness was associated with higher LV twist in asymptomatic CKD; supports hypothesis-generating arterial-myocardial interaction before overt CVD.
BACKGROUND: Recent studies hypothesized left ventricular (LV) twist as a potential biomarker for evaluation of sub clinical myocardial disease, however its relationship with aortic stiffness has yet to be investigated. Chronic kidney disease (CKD) has been identified as a risk factor for both myocardial and arterial disease. As such we sought to explore the relationship between aortic stiffness and LV twist in CKD patients without known cardiovascular disease (CVD). METHODS: In this prospective, observational study we enrolled 106 CKD patients (Stages 1 to 5) with normal LVEF as assessed by conventional echocardiography. Aortic stiffness was measured using aortic pulse wave velocity (aPWV). We defined increased aPWV as ≥10 m/s. LV Twist was measured using two-dimensional speckle tracking echocardiography. RESULTS: Patients with increased aPWV had higher LV twist (p = 0.002) but similar LVEF (p = 0.486). Aortic PWV correlated crudely with age (p < 0.001), the presence of diabetes (p < 0.001), hypertension (p < 0.001), eGFR (p < 0.001), LVMI (p = 0.01), e/e' (p < 0.001) and LV twist (p = 0.003). In multivariable analyses after adjusting for age, gender, cardiovascular risk factors and hypertensive medication, aPWV was independently associated with LV twist (β = 0.163, p = 0.025). CONCLUSIONS: Aortic stiffness independently associates with LV Twist in asymptomatic CKD patients. These findings suggest a close interaction between LV twist mechanics and arterial remodeling even before CVD becomes clinically relevant.
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Sulemane et al. (2015) conducted an observational in Chronic kidney disease (n=106). Increased aortic stiffness (aPWV ≥ 10 m/s) vs. Normal aortic stiffness (aPWV < 10 m/s) was evaluated on Left ventricular twist (β = 0.163, p=0.025). Increased aortic stiffness was independently associated with higher left ventricular twist (β = 0.163, p = 0.025) in asymptomatic patients with chronic kidney disease.
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