P832Vascular-ventricular interaction in chronic kidney disease


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Abstract

Purpose: Chronic kidney disease (CKD) is often associated to left ventricular (LV) dysfunction. Structural alterations of arteries and endothelial dysfunction has also been described in CKD patients. In this study we investigated carotid intima media thickness (IMT) and carotid-femoral pulse wave velocity (PWV) in non heart failure CKD patientsMethods: 55 CKD patients (mean age 48±12.2 years) with preserved LV systolic function (EF: 55±5%) and 35 healthy controls (group C: mean age 45.5±10.1 years) were included. Patients and healthy controls were studied thoroughly by tissue- Doppler- echocardiography and carotid -femoral PWV and carotid IMT were measured. In order to examine left ventricular function patients were divided in 2 groups according to the systolic tissue velocity of the lateral mitral annulus (S') group A - patients without systolic dysfunction : S' >8, group B -patients with latent systolic dysfunction: S'<8.Results: CKD patients had lower systolic tissue velocities (7.8 ± 2,2 vs 10,2 ± 1,0, p<0.001), higher IMT (9,7±1.3 vs 5.8±0.4, p<0.001) and higher PWV(8,2 ±1.1 vs 5.9 ±0.63, p<0.001) compared with the controls. IMT was higher in patients with lower systolic tissue velocities in comparison with the control group(group A:9,4±1.3, group B :11,3±1.6, group C: 5,8 ± 0,4, ANOVA p<0.001) and it was significantly increased in group B of patients with latent systolic dysfunction in comparison to the other two groups (B vs A, C p<0.05). ). PWV showed a statistically significant increase in group B in comparison to groups A and Control group (group A: 8.7±1.7,group B :7,3±0.83, group C: 5,9±0.63, Anova p<0.001), which was also detected between groups A and B (A vs B : p<0.05).Conclusion: PWV and IMT is increased CKD patients with latent systolic dysfunction suggesting an underlying mechanism of ventriculo-vascular interaction in chronic kidney disease.

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