Echocardiographic Assessment of Left Ventricular Multidirectional Deformation in Patients of Hypertension and Chronic Renal Failure with Normal Versus Reduced Left Ventricular Ejection Fraction

Vijayanand Metgudmath, Suresh Patted, Sanjay Porwal, Abhishek Khobragade, Somesh Ishwarappa Gadagi

Background: End-stage renal disease (ESRD) significantly increases cardiovascular (CV) risk, with CV mortality rates 10 to 100 times higher in dialysis patients compared to the general population. Hypertension, a key CV risk factor, contributes to this elevated risk. This study aimed to assess left ventricle (LV) multidirectional deformation in patients of hypertension and chronic renal failure with normal versus reduced LV ejection fraction (LVEF). Materials and methods: This hospital based prospective study was conducted May 2021 to May 2022. Study included 61 patients, aged 18-70 years, with chronic kidney disease (CKD) undergoing dialysis, with good echocardiographic images. Demographic profile (age, gender) of study patients was recorded and they were subjected to trans-thoracic Echocardiography (TTE) evaluation. Data thus collected was subjected to statistical analysis. Results: Majority of patients were in the age group of 40-59 years (44.26%), and 83.61% were male. End Systolic Volume (ESV), End Diastolic Volume (EDV), and LV mass were higher in Reduced LVEF group patients, as compared to Normal LVEF group patients. There was statistically significant correlation of LVEF with both global longitudinal strain (GLS) and global circumferential strain (GCS) (p<0.001). Significant difference was observed in A-velocity (p=0.005), E/A ratio (p=0.009), and deceleration time (p=0.05) between the two study groups Conclusion: Myocardial deformation analysis by GLS and GCS are a good method to assess LV function to detect early heart failure in chronic renal failure patients as compared to previous methods.
PDF