Coronary microcirculation and left ventricular diastolic function but
not myocardial deformation indices are impaired early in patients with
chronic kidney disease
Abstract
Aim. To investigate abnormalities in myocardial strain and
classic echocardiographic indices and coronary flow reserve (CFR), in
younger vs older CKD patients. Methods. Sixty consecutive CKD
patients (<60 years old n=30, ≥60 years old n=30) and 30
healthy controls (age- and gender-matched with younger CKD patients)
were recruited. An echocardiographic assessment including myocardial
strain indices was performed at baseline and following dipyridamole
administration in all participants. Results. Younger CKD
patients had higher E/e’, left ventricular mass index and relative wall
thickness and lower E’ (p<0.005 for all) compared to healthy
controls. Older CKD patients had lower E/A and E’ (p<0.05 for
both) compared to younger CKD patients; these differences did not remain
significant after adjustment for age. CFR was higher in healthy controls
compared to younger and older CKD patients (p<0.05 for both)
without a significant difference between CKD groups.
Dipyridamole-induced changes did not differ significantly among the 3
groups. Conclusions. Compared to healthy controls, impaired
coronary microcirculation and left ventricular diastolic function, but
not myocardial strain abnormalities, are found in young CKD patients and
deteriorate with aging.