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Hypertension and Left Ventricular Strain in Pediatric Chronic Kidney Disease.
Kula, Alexander J; Xu, Yunwen; Hill, Garick D; Furth, Susan L; Warady, Bradley A; Ng, Derek K; Seegmiller, Jeese; Mitsnefes, Mark.
Afiliación
  • Kula AJ; Division of Pediatric Nephrology, Ann and Robert H. Lurie Children's Hospital of Chicago, IL (A.J.K.).
  • Xu Y; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.X., D.K.N.).
  • Hill GD; Division of Pediatric Nephrology (M.M.), Cincinnati Children's Hospital Medical Center, OH.
  • Furth SL; Division of Pediatric Nephrology, Children's Hospital of Philadelphia, PA (S.L.F.).
  • Warady BA; Division of Pediatric Nephrology, Children's Mercy Kansas City, MO (B.A.W.).
  • Ng DK; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.X., D.K.N.).
  • Seegmiller J; Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (J.S.).
  • Mitsnefes M; Division of Pediatric Nephrology (M.M.), Cincinnati Children's Hospital Medical Center, OH.
Hypertension ; 81(10): 2181-2188, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39193718
ABSTRACT

BACKGROUND:

Left ventricular global longitudinal strain (LV GLS) on echocardiography is a sensitive yet clinically significant marker of myocardial dysfunction. Reduced LV GLS is prevalent in adults with chronic kidney disease and hypertension and is associated with adverse cardiovascular outcomes. It may be a biomarker of chronic kidney disease-associated myocardial dysfunction in children, but data are limited. Our objective was to describe LV GLS in the CKiD study (Chronic Kidney Disease in Children) and to examine the association between blood pressure (BP) and reduced LV GLS.

METHODS:

A single apical 4-chamber view was used to estimate LV GLS. Our main analyses examined the association of clinic BP with the absolute value of LV GLS and LV GLS dichotomized at 16. Sensitivity analyses using 24-hour ambulatory BP monitoring data were also performed. Generalized estimating equations were used to account for within-person correlation and to estimate robust SEs for 95% CIs. Covariates in adjusted models included age, sex, race, estimated glomerular filtration rate, urine protein, hemoglobin, left ventricular hypertrophy, and the use of renin-angiotensin system inhibitors.

RESULTS:

LV GLS was measured in 962 person-visits. A total of 77 assessments had an LV GLS <16. In adjusted models, both clinic systolic BP (odds ratio, 1.02 [95% CI, 1.01-1.03]) and diastolic BP (odds ratio, 1.02 [95% CI, 1.00-1.03]) percentiles were associated with LV GLS <16. Having awake or nighttime diastolic BP hypertension on ambulatory BP monitoring was significantly associated with a lower absolute value of LV GLS.

CONCLUSIONS:

Office systolic and diastolic hypertension was associated with diminished LV GLS. Only diastolic hypertension detected on ambulatory BP monitoring was associated with lower LV GLS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ecocardiografía / Disfunción Ventricular Izquierda / Insuficiencia Renal Crónica / Hipertensión Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Hypertension Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ecocardiografía / Disfunción Ventricular Izquierda / Insuficiencia Renal Crónica / Hipertensión Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Hypertension Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos