Universität zu Köln

Lagies, Ruth, ten Cate, Floris E. A. Udink, Feldkoetter, Markus, Beck, Bodo B., Sreeram, Narayanswami, Hoppe, Bernd and Herberg, Ulrike ORCID: 0000-0002-9386-0258 (2019). Subclinical myocardial disease in patients with primary hyperoxaluria and preserved left ventricular ejection fraction: a two-dimensional speckle-tracking imaging study. Pediatr. Nephrol., 34 (12). S. 2591 - 2601. NEW YORK: SPRINGER. ISSN 1432-198X

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Abstract

Background Primary hyperoxaluria (PH) is characterized by progressive chronic kidney disease (CKD) and systemic oxalate deposition. Myocardial dysfunction might be present early in the course of the disease. However, this hypothesis has not yet been tested in the PH population. Therefore, we aimed to determine whether strain imaging using two-dimensional speckle tracking echocardiography (2D-STE) might detect subclinical myocardial disease in otherwise asymptomatic PH patients. Methods Prospective study of pediatric and adolescent PH patients with preserved LV ejection fraction (LV EF) and without renal replacement therapy. Subjects underwent conventional echocardiography and 2D-STE. Global (GLS) and segmental peak systolic LV longitudinal strain (LS) measurements were obtained. Data were compared with age- and gender-matched controls, and Z-scores were calculated as appropriate. Results Fifteen PH patients (age 14.1 +/- 5.9 years; 13/15 in CKD stages 1-2) were studied. Although LV EF was preserved (63 +/- 6%) in patients, GLS was significantly impaired (GLS - 17.1 +/- 2.2% vs - 22.4 +/- 1.9%, p < 0.001). This was mainly due to decreased LS values in the apical segments (p < 0.05). Echocardiographic indices of ventricular wall thickness were significantly increased in patients compared to controls (all p < 0.03). GLS correlated significantly with Z-scores of diastolic interventricular wall thickness (r = - 0.57, p = 0.025) and moderately with serum creatinine levels (r = 0.53, p = 0.044). No correlation was found between GLS and blood pressure measurements. Conclusions Subclinical myocardial disease is already present early in the course of disease in PH patients with preserved LV EF and some degree of renal dysfunction, but without overt systemic oxalosis. Current recommendations to screen only PH patients with advanced CKD for cardiac disease should be revised accordingly.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lagies, Ruth UNSPECIFIED UNSPECIFIED UNSPECIFIED ten Cate, Floris E. A. Udink UNSPECIFIED UNSPECIFIED UNSPECIFIED Feldkoetter, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Beck, Bodo B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sreeram, Narayanswami UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoppe, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Herberg, Ulrike UNSPECIFIED orcid.org/0000-0002-9386-0258 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-125715
DOI:	10.1007/s00467-019-04330-7
Journal or Publication Title:	Pediatr. Nephrol.
Volume:	34
Number:	12
Page Range:	S. 2591 - 2601
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-198X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GLOBAL LONGITUDINAL STRAIN; PRIMARY OXALOSIS; ECHOCARDIOGRAPHIC FEATURES; INTERSTITIAL FIBROSIS; CHILDREN; DYSFUNCTION; ABNORMALITIES; ADOLESCENTS; DIAGNOSIS; FAILURE Multiple languages Pediatrics; Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12571