The association between systolic and diastolic dysfunction and autonomic nervous system function in children receiving chronic hemodialysis

被引:1
作者
Abd Elaziz, Ola H. [1 ]
Ahmad, Ghada M. S. [1 ]
Abd Elgawad, Salwa S. [2 ]
Elhady, Fatma [1 ]
Hamdy, Rehab M. [1 ]
机构
[1] Al Azhar Univ, Fac Med Girls, Cardiol Dept, Cairo, Egypt
[2] Al Azhar Univ, Fac Med Girls, Pediat Dept, Cairo, Egypt
关键词
Chronic kidney disease; Speckle tracking echocardiography; Heart rate variability; Global longitudinal shortening; CHRONIC KIDNEY-DISEASE; SPECKLE-TRACKING ECHOCARDIOGRAPHY; SUDDEN CARDIAC DEATH; 3-DIMENSIONAL ECHOCARDIOGRAPHY; LONGITUDINAL STRAIN; PEDIATRIC DIALYSIS; MORTALITY; DEFORMATION;
D O I
10.1007/s00467-024-06577-1
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background Changes in cardiac function and structure as well as their association with the cardiac autonomic nervous system remain incompletely characterized in children with stage 5 chronic kidney disease (CKD) receiving hemodialysis (HD). Methods A prospective observational cohort study was conducted on 40 Egyptian children with CKD on regular HD compared to 40 age- and sex-matched healthy children. All participants underwent thorough clinical examination, laboratory investigations, 24-h Holter monitoring, and 2D/4D echocardiographic study (conventional and advanced modalities). Participants were followed for mortality and morbidity over 36 months. Results Following HD sessions, CKD children showed significant reductions of left and right ventricular (LV/RV) systolic function by 2D and 4D echocardiography compared to controls. HD children had significant impairment of heart rate variability parameters (evaluated by time and frequency domains). LV/RV global longitudinal shortening (GLS) as well as tricuspid annular plane systolic excursion were closely correlated with different Holter parameters, including frequency domain parameters (including low frequency, high frequency, and LF/HF ratio), time domain parameters including percentage of differences > 50 ms between consecutive normal RR intervals (pNN50), and root-mean-square of the difference between successive normal intervals (rMSSD). Over a follow-up of 34.5 +/- 16.8 months, 10 (25%) patients died. Reduced LV/RV-GLS and decreased rMSSD values were independently associated with higher mortality among HD children. Conclusions LV and RV myocardial deformation (either 2D or 4D) primarily decreased in HD children. Altered time and frequency domain indices revealed cardiac autonomic dysfunction, evidenced by increased sympathetic activity and decreased vagal activity. Reduced LV/RV-GLS and decreased rMSSD values were independently associated with higher mortality among HD children.
引用
收藏
页数:12
相关论文
共 51 条
[1]  
[Anonymous], 2019, Am J Kidney Dis, DOI 10.1053/j.ajkd.2019.09.002
[2]  
Atkinson MA, 2021, Management of anemia in children receiving chronic dialysis BTpediatric dialysis, P609, DOI [10.1007/978-3-030-66861-732, DOI 10.1007/978-3-030-66861-732]
[3]   A Longitudinal Study of Left Ventricular Function and Structure from CKD to ESRD: The CRIC Study [J].
Bansal, Nisha ;
Keane, Martin ;
Delafontaine, Patrice ;
Dries, Daniel ;
Foster, Elyse ;
Gadegbeku, Crystal A. ;
Go, Alan S. ;
Hamm, L. Lee ;
Kusek, John W. ;
Ojo, Akinlolu O. ;
Rahman, Mahboob ;
Tao, Kaixiang ;
Wright, Jackson T. ;
Xie, Dawei ;
Hsu, Chi-Yuan .
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2013, 8 (03) :355-362
[4]   Strain and strain rate imaging: a promising tool for evaluation of ventricular function [J].
Baur, L. H. B. .
INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 2008, 24 (05) :493-494
[5]   Management of Anemia in Children Receiving Chronic Peritoneal Dialysis [J].
Borzych-Duzalka, Dagmara ;
Bilginer, Yelda ;
Ha, Il Soo ;
Bak, Mustafa ;
Rees, Lesley ;
Cano, Francisco ;
Loza Munarriz, Reyner ;
Chua, Annabelle ;
Pesle, Silvia ;
Emre, Sevinc ;
Urzykowska, Agnieszka ;
Quiroz, Lily ;
Dario Ruscasso, Javier ;
White, Colin ;
Pape, Lars ;
Ramela, Virginia ;
Printza, Nikoleta ;
Vogel, Andrea ;
Kuzmanovska, Dafina ;
Simkova, Eva ;
Mueller-Wiefel, Dirk E. ;
Sander, Anja ;
Warady, Bradley A. ;
Schaefer, Franz .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2013, 24 (04) :665-676
[6]   Hemodialysis-Induced Repetitive Myocardial Injury Results in Global and Segmental Reduction in Systolic Cardiac Function [J].
Burton, James O. ;
Jefferies, Helen J. ;
Selby, Nicholas M. ;
McIntyre, Christopher W. .
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2009, 4 (12) :1925-1931
[7]   Left ventricular myocardial function in hemodialysis patients: the effects of preload decrease in conventional, Doppler and speckle tracking echocardiography parameters [J].
Charfeddine, Salma ;
Abid, Leila ;
Hammami, Rania ;
Bahloul, Amine ;
Triki, Faten ;
Kammoun, Samir .
PAN AFRICAN MEDICAL JOURNAL, 2021, 38 :1-14
[8]   Assessment of Cardiac Function in Children by Strain Imaging and its Correlation with Conventional Echocardiographic Parameter [J].
Chatterjee, Suman ;
Mukherjee, Somnath ;
Rani, Neha ;
Kumar, Prashant ;
Kumar, Prakash ;
Sarkar, Achyut .
ANNALS OF CARDIAC ANAESTHESIA, 2022, 25 (03) :264-269
[9]   Sudden cardiac death and chronic kidney disease: From pathophysiology to treatment strategies [J].
Di Lullo, L. ;
Rivera, R. ;
Barbera, V. ;
Bellasi, A. ;
Cozzolino, M. ;
Russo, D. ;
De Pascalis, A. ;
Banerjee, D. ;
Floccari, F. ;
Ronco, C. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2016, 217 :16-27
[10]   Cardiovascular risk in children and adolescents with end stage renal disease [J].
do Val, Maria Luiza ;
Menezes, Fernanda Souza ;
Massaoka, Henrique Tsuha ;
Scavarda, Valeska Tavares ;
Czapkowski, Adriano ;
Leite, Heitor Pons ;
Moises, Valdir Ambrosio ;
Ajzen, Sergio Aron ;
de Abreu Carvalhaes, Joao Tomas ;
Medina Pestana, Jose Osmar ;
Koch-Nogueira, Paulo .
CLINICS, 2019, 74