title: Impaired longitudinal deformation measured by speckle-tracking echocardiography in children with end-stage renal disease.
abstract: Left ventricular dysfunction is an important co-morbidity of end-stage renal disease (ESRD) and is associated with a poor prognosis in the adult population. In pediatric ESRD, left ventricular function is generally well preserved, but limited information is available on early changes in myocardial function. The aim of this study was to investigate myocardial mechanics in pediatric patients with ESRD using speckle-tracking echocardiography (STE).
  
  
  
  Echocardiographic studies, including M-mode, tissue Doppler imaging (TDI) and STE, were performed in 19 children on dialysis, 17 transplant patients and 33 age-matched controls. Strain measurements were performed from the apical four-chamber and the short axis view, respectively.
  
  
  
  The interventricular and left ventricular posterior wall thickness was significantly increased in dialysis and transplant patients compared to healthy controls. No significant differences were found in shortening fraction, ejection fraction and systolic tissue Doppler velocities. Dialysis and transplant patients had a decreased mean longitudinal strain compared to healthy controls, with a mean difference of 3.1 [95 % confidence interval (CI) 2.0-4.4] and 2.7 (95 % CI 1.2-4.2), respectively. No differences were found for radial and circumferential strain.
  
  
  
  Speckle-tracking echocardiography may reveal early myocardial dysfunction in the absence of systolic dysfunction measured by conventional ultrasound or TDI in children with ESRD.
authors.affiliation: Department of Pediatric Nephrology, Emma Children's Hospital, Academic Medical Center (AMC) Amsterdam/University of Amsterdam, Amsterdam, The Netherlands. maikevanhuis@gmail.com.
authors.forename: Maike
authors.initials: M
authors.lastname: van Huis
authors.affiliation: Department of Pediatric Nephrology, Emma Children's Hospital, Academic Medical Center (AMC) Amsterdam/University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Nikki J
authors.initials: NJ
authors.lastname: Schoenmaker
authors.affiliation: Department of Pediatric Nephrology, Emma Children's Hospital, Academic Medical Center (AMC) Amsterdam/University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Groothoff
authors.affiliation: Pediatric Clinical Research Office, Emma Children's Hospital, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Johanna H
authors.initials: JH
authors.lastname: van der Lee
authors.affiliation: Department of Pediatric Nephrology, University Hospital Leuven, Leuven, Belgium.
authors.forename: Maria
authors.initials: M
authors.lastname: van Dyk
authors.affiliation: Department of Pediatric Cardiology, University Hospital Leuven, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Gewillig
authors.affiliation: Department of Pediatric Nephrology, University Medical Center (UMC) St. Radboud/Radboud University, Nijmegen, The Netherlands.
authors.forename: Linda
authors.initials: L
authors.lastname: Koster
authors.affiliation: Department of Pediatric Cardiology, UMC St. Radboud/Radboud University, Nijmegen, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Tanke
authors.affiliation: Department of Pediatric Nephrology, Wilhelmina Children's Hospital, UMC Utrecht/Utrecht University, Utrecht, The Netherlands.
authors.forename: Marc
authors.initials: M
authors.lastname: Lilien
authors.affiliation: Department of Pediatric Cardiology, Emma Children's Hospital, AMC Amsterdam/University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Nico A
authors.initials: NA
authors.lastname: Blom
authors.affiliation: Cardiology, The Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada.
authors.forename: Luc
authors.initials: L
authors.lastname: Mertens
authors.affiliation: Department of Pediatric Cardiology, Emma Children's Hospital, AMC Amsterdam/University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Irene M
authors.initials: IM
authors.lastname: Kuipers
mesh_terms: D002648:Child; D004452:Echocardiography; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D006435:Renal Dialysis; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology*; D016277:Ventricular Function, Left
keywords: Cardiovascular Imaging; Children; Longitudinal strain; Pediatric; Systolic dysfunction