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Pediatric Nephrology

Erschienen in:

01.02.2016 | Original Article

Left ventricular mass and systolic function in children with chronic kidney disease—comparing echocardiography with cardiac magnetic resonance imaging

verfasst von: Raoul Arnold, Daniel Schwendinger, Sabine Jung, Martin Pohl, Bernd Jung, Julia Geiger, Charlotte Gimpel

Erschienen in: Pediatric Nephrology | Ausgabe 2/2016

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Abstract

Background

Increased left ventricular mass (LVM) is an important risk marker of uremic cardiovascular disease. Calculation of LVM by echocardiography (Echo) relies on geometric assumptions and in adults on hemodialysis overestimates LVM compared to cardiac magnetic resonance (CMR). We compare both techniques in children with chronic kidney disease (CKD).

Methods

Concurrent Echo and CMR was performed in 25 children with CKD (14 after kidney transplantation) aged 8–17 years.

Results

Compared to normal children, CMR-LVM was increased (standard deviation score (SDS) 0.39 ± 0.8 (p = 0.03)), stroke volume and cardiac output decreased (SDS −1.76 ± 1.1, p = 0.002 and −1.11 ± 2.0, p = 0.001). CMR-LVM index but not Echo-LVMI correlated to future glomerular filtration rate (GFR) decline (r = −0.52, p = 0.01). Mean Echo-LVM was higher than CMR-LVM (117 ± 40 vs. 89 ± 29 g, p < 0.0001), with wide limits of agreement (−6.2 to 62.8 g). The Echo-CMR LVM difference increased with higher Echo-LVMI (r = 0.77, p < 0.0001). Agreement of classifying left ventricular hypertrophy was poor with Cohen’s kappa of 0.08. Mean Echo and CMR-ejection fraction differed by 1.42 % with wide limits of agreement (−12.6 to 15.4 %).

Conclusions

Echo overestimates LVM compared to CMR, especially at higher LVM. Despite this, CMR confirms increased LVM in children with CKD. Only CMR-LVMI but not Echo-LVMI correlated to future GFR decline.

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BSA

Body surface area

CMR(−)

Cardiac magnetic resonance/measured by CMR

Echo(−)

Echocardiography/ echocardiographicaly measured

Ejection fraction

LVM

Left ventricular mass

LVH

Left ventricular hypertrophy

LVMI

LVM indexed to height in m^2.7

LVMBSA

LVM normalized to body surface area

ABPM

24-hour ambulatory blood pressure measurement

CKD

Chronic kidney disease

Confidence interval

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Titel: Left ventricular mass and systolic function in children with chronic kidney disease—comparing echocardiography with cardiac magnetic resonance imaging
verfasst von: Raoul Arnold
Daniel Schwendinger
Sabine Jung
Martin Pohl
Bernd Jung
Julia Geiger
Charlotte Gimpel
Publikationsdatum: 01.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 2/2016
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-015-3198-z

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Left ventricular mass and systolic function in children with chronic kidney disease—comparing echocardiography with cardiac magnetic resonance imaging