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August 7, 2019Scientific ReportsOpen Access

Impaired Systolic and Diastolic Left Ventricular Function in Children with Chronic Kidney Disease - Results from the 4C Study

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Why the study?

Children with chronic kidney disease face excessive cardiovascular mortality and early cardiovascular alterations, but whether tissue Doppler imaging reveals reduced cardiac function compared to healthy children was unconfirmed.

Population

128 children aged 6–17 years with CKD and eGFR below 60 ml/min/1.73 m 2

Comparison

Cardiac tissue Doppler measurements vs published healthy reference data

Design

Cross-sectional echocardiographic study

Key result

Children with chronic kidney disease demonstrated significantly impaired diastolic function compared to healthy children, evidenced by a reduced tissue Doppler E'/A' ratio Z-score of -0.14 (p < 0.0001).

Authors

ADAnke DoyonPHPascal HaasSESevcan Erdem

Discussion

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Overview

May support cardiac screening in pediatric CKD; hypothesis-generating for prognostic value and interventions.

Study Design

Type

Cross-Sectional (n=128)

Multicenter

Yes

Structured PICO

P
Population
128 children aged 6-17 years with chronic kidney disease (eGFR < 60 ml/min/1.73 m2) from the 4C Study, mean age 12.7 years, 72.7% male, multinational.
C
Comparator
Published reference data of 325 healthy children
O
Outcome
Systolic and diastolic left ventricular function assessed by tissue Doppler velocities (E', A', S', E'/A', E/E') normalized to z-scoressurrogate

Main Result

p-value: p=<0.0001

Tissue Doppler imaging reveals early subclinical systolic and diastolic left ventricular dysfunction in children with chronic kidney disease, which correlates with eGFR and blood pressure.

Limitations

  • Cross-sectional design precludes firm conclusions about causalities
  • Fluid status was not assessed directly
  • Tissue Doppler measurements were an ancillary measurement only available in a subset of patients seen by one investigator

Cite This Study

Doyon et al. (2019) conducted a cross-sectional in Chronic Kidney Disease (n=128). Chronic Kidney Disease vs. Healthy children (reference data) was evaluated on Tissue Doppler E'/A' ratio Z-score (p=<0.0001). Children with chronic kidney disease demonstrated significantly impaired diastolic function compared to healthy children, evidenced by a reduced tissue Doppler E'/A' ratio Z-score of -0.14 (p < 0.0001).

synapsesocial.com/papers/6a13929b7fc80bf722c65f18https://doi.org/10.1038/s41598-019-46653-3
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