title: Myocardial ultrasound tissue characterization in patients with chronic renal failure.
abstract: The objective of this study was to detect ultrastructural changes in myocardium related to collagen content by ultrasound tissue characterization in patients with chronic kidney disease (CKD) and in uncomplicated hypertensive control subjects. In 25 hemodialysis (HD) patients, in 25 patients with moderate to severe chronic renal failure (CRF), and in 10 patients with essential hypertension (EH) and normal renal function matched for age, BP, and left ventricular mass index, left ventricular anatomy and function were evaluated by conventional echocardiography, and integrated backscatter signal (IBS) was analyzed by acoustic densitometry. IBS mean reflectivity increased from 48% in patients with EH to 56% in patients with CRF to 62% in HD patients (ANOVA P < 0.01). IBS mean cyclic variation was progressively increased from 4.35 +/- 1.2 dB in HD patients to 5.27 +/- 0.90 in patients with CRF to 6.50 +/- 1.6 dB in patients with EH (ANOVA P < 0.01). At multivariate analysis, IBS mean reflectivity was positively related to age and serum creatinine (beta 0.351, P = 0.036; and beta = 0.408, P = 0.016, respectively). IBS mean cyclic variation was inversely related to age and serum creatinine (beta = -0.274, P = 0.025; and beta = -0.262, P = 0.025, respectively) and positively related to left ventricular midwall fractional shortening and transmitral E/A ratio (beta = 0.269, P < 0.05; and beta = 0.314, P < 0.001, respectively). The data support the hypothesis that interstitial collagen deposition may appear early in the course of CKD and suggest that acoustic densitometry may represent a useful tool for the assessment of myocardial tissue changes in patients with CKD.
authors: Department of Medical and Surgical Sciences, University of Brescia, c/o Spedali Civili, 2a Medicina, Brescia 25100, Italy. salvetti@med.unibs.it
authors: Massimo
authors: M
authors: Salvetti
authors: Maria Lorenza
authors: ML
authors: Muiesan
authors: Anna
authors: A
authors: Paini
authors: Cristina
authors: C
authors: Monteduro
authors: Bianca
authors: B
authors: Bonzi
authors: Gloria
authors: G
authors: Galbassini
authors: Eugenia
authors: E
authors: Belotti
authors: Ezio
authors: E
authors: Movilli
authors: Giovanni
authors: G
authors: Cancarini
authors: Enrico
authors: E
authors: Agabiti-Rosei
mesh_terms: D000368:Aged; D003094:Collagen / Q000378:metabolism; D003720:Densitometry / Q000295:instrumentation / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000000981:diagnostic imaging*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D016277:Ventricular Function, Left
chemical_list: D003094:Collagen