Assessments of left ventricular systolic and diastolic functions with tissue Doppler imaging and myocardial performance index in children with chronic kidney disease.

BACKGROUND This study aimed to document early left ventricular (LV) dysfunction in chronic kidney disease (CKD) using methods such as tissue Doppler imaging (TDI) and myocardial performance index (MPI). METHODS A total of 40 patients diagnosed with CKD (mean age, 10.1 ± 4.1 years) and 40 sex- and age- matched healthy controls (mean age, 9.6 ± 4.3 years) were examined. In the patient group, 20 patients had early-stage (Stage 2-3) and 20 patients had late-stage (stage 4-5) CKD, and 18 patients had hypertension. RESULTS Pulmonary artery systolic pressure (PAPs), and LV mass index (LVMI) were significantly higher in the patient group (P< 0.05). LV septal and lateral margins of the mitral annulus E'/A' ratio, E/E' ratio, and MPI results were statistically significantly different in between the groups (P< 0.05). MPI were higher in late-stage CKD than in early-stage CKD (P< 0.05). The E'/A' ratio was lower and the MPI was higher in the hypertensive CKD group compared with the normotensive CKD group (P< 0.05). The E/E' ratio was correlated positively with LVMI, PAPs; negatively with glomerular filtration rate, S' value, E'/A' ratio. The MPI was correlated positively with blood pressure, LVMI, PAPs, S value; negatively with the E'/A' ratio. CONCLUSIONS E'/A' ratio, E/E' ratio, and IVRT measured by TDI are highly accurate and easily applicable for detecting diastolic LV function, and the MPI is suitable for detecting both systolic and diastolic LV dysfunction. Their routine use may be useful in evaluating LV functions in children with CKD.