Global longitudinal strain is superior to ejection fraction for detecting myocardial dysfunction in end-stage renal disease with hyperparathyroidism.
Maria Fernanda Carrasco-Ruiz, Antonio Ruiz-Rivera, Marvin A Soriano-Ursúa, Carlos Martinez-Hernandez, Leticia Manuel-Apolinar, Carmen Castillo-Hernandez, Gustavo Guevara-Balcazar, Eunice D Farfán-García, Ana Mejia-Ruiz, Ivan Rubio-Gayosso, Teresa Perez-Capistran
Author Information
Maria Fernanda Carrasco-Ruiz: Department of Physiology, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico.
Antonio Ruiz-Rivera: Department of Cardiology, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico.
Marvin A Soriano-Ursúa: Department of Physiology, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico.
Carlos Martinez-Hernandez: Department of Cardiology, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico.
Leticia Manuel-Apolinar: Endocrine Research Unit, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico.
Carmen Castillo-Hernandez: Department of Cardiovascular Pharmacology, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico.
Gustavo Guevara-Balcazar: Department of Cardiovascular Pharmacology, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico.
Eunice D Farfán-García: Department of Biochemistry, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico.
Ana Mejia-Ruiz: Education Research, Comisión Nacional Para la Mejora Continua de la Educación, Ciudad de México 03900, Mexico.
Ivan Rubio-Gayosso: Postgraduate Studies and Research Section,Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico.
Teresa Perez-Capistran: Department of Physiology, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico.
BACKGROUND: The estimation of left ventricular ejection fraction (LVEF) by 2D echocardiography (2D-ECHO) is the most used tool to assess LV systolic function (LVSF). Global longitudinal strain (GLS) has recently been suggested as a superior method for several evaluations. This study explored the association and prevalence of LV systolic dysfunction (LVSD) by using these methods in patients with end-stage renal disease (ESRD) and severe hyperparathyroidism (SHPTH); both associated with cardiovascular events (CEs). AIM: To evaluate the myocardial function in patients with ESRD and SHPTH by using the GLS and LVEF measured through conventional 2D-ECHO. METHODS: In 62 patients with ESRD and SHPTH, asymptomatic, and without a history of CEs, LVSF was evaluated by 2D-ECHO, obtaining the EF, by the Simpson biplane method, and GLS by speckle tracking. RESULTS: The total patients with ESRD had a preserved LVEF (> 50%) but abnormal GLS (< 13.55%). Additionally, multivariate analysis showed an independent association of GLS and serum parathyroid hormone (PTH), LV mass index, and hemoglobin. Also, PTH was independently associated with lateral e' wave and tricuspid regurgitation velocity. CONCLUSION: In patients with SHPTH linked to ESRD, the use of GLS by 2D-ECHO is a more sensitive tool than LVEF for detecting LVSD.
