title: Assessment of left ventricular function by tissue Doppler echocardiography in pediatric chronic kidney disease.
abstract: BACKGROUND
  Cardiovascular (CV) disease remains the most common cause of mortality in chronic kidney disease (CKD).
  
  
  METHODS
  In this cross-sectional study, 43 pediatric patients with CKD were divided into two groups according to their estimated glomerular filtration rate (eGFR): groups 1 and 2 (eGR; 29-75 and 15-29 mL/min/1.73 m(2), respectively). M - mode, conventional pulsed wave Doppler (cPWD) echocardiography and tissue Doppler imaging (TDI) were performed in all patients and 16 healthy controls. Maximal early (E wave) and late (A wave) diastolic flow velocities were assessed by cPWD. Using TDI, the early (E') and late (A') diastolic filling velocities were recorded. Early and late diastoles were evaluated using E' values and E/E' ratios, respectively.
  
  
  RESULTS
  Left ventricular hypertrophy (LVH) was determined in 19/43 (44.2%) patients. The E/E' ratio was significantly higher in group 2 than in group 1 and controls. E/E' was found to be positively correlated with left ventricular mass (LVM) index, and negatively with hemoglobin (Hb) levels. Low Hb levels were only independent predictor of E/E' (p = 0.001, β: -0.470, 95% CI: -0.764; -0.196). E' ratio was significantly lower in both patient groups compared to the controls.
  
  
  CONCLUSIONS
  LVH and diastolic dysfunction are already present in early stages of CKD. Treatment of risk factors, such as anemia, is important to improve the clinical outcome.
authors.affiliation: a Division of Pediatric Nephrology , University of Akdeniz , Antalya , Turkey .
authors.forename: Cagla Serpil
authors.initials: CS
authors.lastname: Dogan
authors.affiliation: a Division of Pediatric Nephrology , University of Akdeniz , Antalya , Turkey .
authors.forename: Sema
authors.initials: S
authors.lastname: Akman
authors.affiliation: b Division of Pediatric Cardiology , University of Akdeniz , Antalya , Turkey , and.
authors.forename: Ayse
authors.initials: A
authors.lastname: Simsek
authors.affiliation: c Department of Medical Biochemistry , University of Akdeniz , Antalya , Turkey.
authors.forename: Sebahat
authors.initials: S
authors.lastname: Ozdem
authors.affiliation: a Division of Pediatric Nephrology , University of Akdeniz , Antalya , Turkey .
authors.forename: Elif
authors.initials: E
authors.lastname: Comak
authors.affiliation: a Division of Pediatric Nephrology , University of Akdeniz , Antalya , Turkey .
authors.forename: Arife Uslu
authors.initials: AU
authors.lastname: Gokceoglu
authors.affiliation: b Division of Pediatric Cardiology , University of Akdeniz , Antalya , Turkey , and.
authors.forename: Fırat
authors.initials: F
authors.lastname: Kardelen
authors.affiliation: a Division of Pediatric Nephrology , University of Akdeniz , Antalya , Turkey .
authors.forename: Mustafa
authors.initials: M
authors.lastname: Koyun
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging*; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*
keywords: Child; chronic kidney disease; conventional pulsed wave Doppler echocardiography; left ventricular function; tissue Doppler imaging