title: Incremental value of global longitudinal strain in prediction of all-cause mortality in predialysis and dialysis chronic kidney disease patients.
abstract: BACKGROUND
  The aim of this prospective study was to investigate the prediction of all-cause mortality from global longitudinal strain (GLS) in two groups of chronic kidney disease patients (CKD): predialysis and dialysis.
  
  
  METHODS
  In 89 patients undergoing echocardiography, 37.2 % predialysis (16/43) and 58.6 % dialysis patients (27/46) died during the mean follow-up 70.2 ± 35 months. In addition to conventional echocardiographic measurements, GLS was assessed by velocity vector imaging from three standard apical views.
  
  
  RESULTS
  Cox proportional hazards regression enter model showed the following variables to predict survival: the only significant predictor of survival in predialysis patients, among the set of conventional echocardiographic parameters was GLS (HR, 0.58; 95 % CI, 0.39-0.87; p = 0.01). In the group of dialysis patients GLS with E/Em ratio remained as significant predictors of survival (HR, 0.72; 95 % CI, 0.56-0.92; p = 0.01, and HR, 1.02; 95 % CI, 1.004-1.04; p = 0.01, respectively). GLS ≥ - 13.2 % had 58.3 % sensitivity and 91.7 % specificity for prediction of mortality in predialysis patients, and GLS ≥ - 12.02 % had 73.3 % sensitivity and 78.9 % specificity for prediction of mortality in dialysis patients. In dialysis group E/Em ratio ˃ 17.02 had 71.4 % sensitivity and 84.2 % specificity for prediction of mortality.
  
  
  CONCLUSIONS
  Our study demonstrates the incremental value of GLS in prediction of all-cause mortality during a long follow-up period in CKD patients. GLS together with E/Em ratio may be used for the assessment of left ventricular systolic and diastolic function and risk stratification of CKD patients in different stages of renal failure.
authors.affiliation: 1st Department of Internal Medicine, Safarik University Hospital, tr SNP 1, 040 11, Kosice, Slovakia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Valocikova
authors.affiliation: Department of Cardiology, The East Slovak Institute of Cardiovascular Diseases and Safarik University, Ondavska 8, 040 11, Kosice, Slovakia. marianna.vachalcova@gmail.com.
authors.forename: Marianna
authors.identifier: http://orcid.org/0000-0002-6653-6559
authors.initials: M
authors.lastname: Vachalcova
authors.affiliation: Department of Cardiology, The East Slovak Institute of Cardiovascular Diseases and Safarik University, Ondavska 8, 040 11, Kosice, Slovakia.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Valocik
authors.affiliation: Department of Cardiology, The East Slovak Institute of Cardiovascular Diseases and Safarik University, Ondavska 8, 040 11, Kosice, Slovakia.
authors.forename: Marian
authors.initials: M
authors.lastname: Kurecko
authors.affiliation: Department of Cardiology, The East Slovak Institute of Cardiovascular Diseases and Safarik University, Ondavska 8, 040 11, Kosice, Slovakia.
authors.forename: Mariana
authors.initials: M
authors.lastname: Dvoroznakova
authors.affiliation: Department of Cardiology, The East Slovak Institute of Cardiovascular Diseases and Safarik University, Ondavska 8, 040 11, Kosice, Slovakia.
authors.forename: Peter
authors.initials: P
authors.lastname: Mitro
authors.affiliation: Department of Cardiology, The East Slovak Institute of Cardiovascular Diseases and Safarik University, Ondavska 8, 040 11, Kosice, Slovakia.
authors.forename: Jozefina
authors.initials: J
authors.lastname: Cocherova
authors.affiliation: Department of Cardiology, The East Slovak Institute of Cardiovascular Diseases and Safarik University, Ondavska 8, 040 11, Kosice, Slovakia.
authors.forename: Stanislava Buday
authors.initials: SB
authors.lastname: Bujnakova
authors.affiliation: Department of Cardiology, The East Slovak Institute of Cardiovascular Diseases and Safarik University, Ondavska 8, 040 11, Kosice, Slovakia.
authors.forename: Dusan
authors.initials: D
authors.lastname: Holoubek
mesh_terms: D000368:Aged; D015984:Causality; D015897:Comorbidity; D004452:Echocardiography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000401:mortality* / Q000706:statistics & numerical data; D051436:Renal Insufficiency, Chronic / Q000401:mortality* / Q000628:therapy*; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D016019:Survival Analysis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*
keywords: Chronic kidney disease; Global longitudinal strain; Mortality