Application value of echocardiography in screening of cardiovascular disease in patients with chronic kidney disease
DONG Xin1 LI Renwu2 JI Limei2
1.Department of Ultrasonography, Shunyi Hospital of Beijing Chinese Medicine Hospital, Beijing 101300, China;
2.Department of Nephrology, Shunyi Hospital of Beijing Chinese Medicine Hospital, Beijing 101300, China
Abstract:Objective To investigate the value of echocardiography in screening of cardiovascular disease in patients with chronic kidney disease (CKD). Methods From September 2013 to July 2016, in Shunyi Hospital of Beijing Chinese Medicine Hospital ("our hospital" for short), 78 CKD patients were selected as the CKD group, and 78 healthy volunteers in our hospital were selected as the control group at the same period, the general survey data, echocardiography imaging and renal function index were recorded and given correlation analysis. Results There were no statistically significant differences in gender, age, systolic blood pressure, diastolic blood pressure, body mass index between the two groups (P > 0.05). The LAD, LVDd, LVDs, LVESV, LVEDV, E/A in the CKD group were (37.11±2.19) cm, (5.11±0.44) cm, (3.69±0.83) cm, (49.20±11.49) mL, (108.33±22.19) mL and (1.02±0.32), thoes in the control group were (34.11±3.10) cm, (4.72±0.44) cm, (2.93±0.44) cm, (25.02±5.66) mL and (76.20±13.10) mL and (1.27±0.44), there were statistically significant differences between the two groups in this index (P < 0.05). The Cr and BUN values of the CKD group were significantly higher than those of the control group, the differences were statistically significant (P < 0.05). There were no significant differences in UA, Hb, TG and LDL-C between the two groups (P > 0.05). In the CKD group, Pearson coefficient correlation analysis showed that LAD, LVDd, LVDs, LVESV, LVEDV were significantly positively correlated with Cr (r = 0.334, 0.514, 0.442, 0.298, 0.332, P < 0.05), E/A was negatively correlated with Cr (r = -0.345, P < 0.05), LAD, LVDd were positively correlation to BUN(r = 0.442, 0.301, P < 0.05). Multivariate regression analysis showed that LAD, LVDd, LVDs, E/A were the main independent risk factors for Cr (P < 0.05), LAD and LVDd were the main independent risk factors for BUN (P < 0.05). Conclusion The application of echocardiography in the screening of cardiovascular disease in patients with chronic kidney disease can effectively reflect the state of the heart function and the condition of the patients, and it is closely related to the routine indexes of renal function.
董鑫1 李仁武2 纪利梅2. 超声心动图在慢性肾脏病患者心血管疾病筛查中的应用价值[J]. 中国医药导报, 2017, 14(28): 121-124,132.
DONG Xin1 LI Renwu2 JI Limei2. Application value of echocardiography in screening of cardiovascular disease in patients with chronic kidney disease. 中国医药导报, 2017, 14(28): 121-124,132.
[1] Shemirani H, Tavakol S, Atapoor A, et al. The role of inflammatory processes in occurrence of left ventricular failure in patients with chronic kidney disease [J]. Adv Biomed Res,2017,22(6):13-19.
[2] Rumman RK,Ramroop R,Chanchlani R,et al. Longitudinal assessment of myocardial function in childhood chronic kidney disease,during dialysis,and following kidney transplantation [J]. Pediatr Nephrol,2017,3(8):5864-5869.
[3] Huang JC,Chen SC,Tsai YC,et al. Prognostic significance of left ventricular mass index and renal function decline rate in chronic kidney disease G3 and G4 [J]. Sci Rep,2017,14(7):42578-42591.
[4] 芦照青,王国兴,刘凤奎,等.急性心力衰竭患者NT-proBNP水平、影响因素及其与容量负荷和预后的相关性研究[J].临床和实验医学杂志,2017,16(2):163-166.
[5] Antlanger M,Aschauer S,Kopecky C,et al. Heart failure with preserved and reduced ejection fraction in hemodialysis patients: prevalence,disease prediction and prognosis [J]. Kidney Blood Press Res,2017,42(1):165-176.
[6] Kitamura K,Fujii H,Nakai K,et al. Relationship between cardiac calcification and left ventricular hypertrophy in patients with chronic kidney disease at hemodialysis initiation [J]. Heart Vessels,2017,4(21:126-134.
[7] 郭正勇,许洪涛,张苗.CKDⅢ~Ⅴ期糖尿病肾病患者贫血特点分析[J].浙江临床医学,2016,18(7):1217-1219.
[8] Dehghan Manshadi SA,Rezahosseini O,Abdi Liaei Z. Brucellosis with multi-organ involvement in a patient with history of composite aortic graft and hepatitis B [J]. Acta Med Iran,2016,54(11):750-753.
[9] Horio T,Akiyama M,Iwashima Y,et al. Preventive effect of renin-angiotensin system inhibitors on new-onset atrial fibrillation in hypertensive patients:a propensity score matching analysis [J]. J Hum Hypertens,2016,12(29):95-109.
[10] 周杨,王瑞娟,吕颖,等.血NT-ProBNP对CKD非透析患者有效循环血容量评价的研究[J].中国中西医结合肾病杂志,2016,17(4):335-337.
[11] Luo M,Lin J,Qin Z,et al. Prevention preferable to treatment: 3 case reports of patients experiencing right-sided heart failure after Ebstein anomaly correction [J]. Medicine (Baltimore),2017,96(1):e5627.
[12] Dubin RF,Deo R,Bansal N,et al. Associations of conventional echocardiographic measures with incident heart failure and mortality: the chronic renal insufficiency cohort [J]. Clin J Am Soc Nephrol,2017,12(1):60-68.
[13] 韩蓓蓓,李永光,董志峰,等.肾功能不全影响NT-proBNP对急性心肌梗死患者心功能的预测价值[J].中国医师杂志,2016,18(10):1531-1533.
[14] Oguz EG,Akoglu H,Okyay GU,et al. Increased serum renalase in peritoneal dialysis patients:is it related to cardiovascular disease risk? [J]. Nefrologia,2017,2(1):208-209.
[15] Kim JK,Song YR,Park G,et al. Impact of rapid ultrafiltration rate on changes in the echocardiographic left atrial volume index in patients undergoing haemodialysis:a longitudinal observational study [J]. BMJ Open,2017,7(2):e013990.
[16] 高小群,廉哲勋,齐玉军,等.肾功能损伤对N末端B型利钠肽原应用于心力衰竭诊断的影响[J].中国循环杂志,2016,31(12):1189-1193.
[17] Ishikawa S,Sugioka K,Sakamoto S,et al. Relationship between tissue Doppler measurements of left ventricular diastolic function and silent brain infarction in patients with non-valvular atrial fibrillation [J]. Eur Heart J Cardiovasc Imaging,2016,12(29):9210-9219.
[18] Hai JJ,Chan PH,Chan YH,et al. Prediction of thromboembolic events in heart failure patients in sinus rhythm:the Hong Kong Heart Failure Registry [J]. PLoS One,2016, 11(12):e0169095.
[19] 于彤彤,王传合,刘双双,等.舒张性心力衰竭患者长期预后的性别差异[J].上海交通大学学报:医学版,2016, 36(2):278-284.
[20] 李娅,宗雪,吕轶伦,等.慢性肾脏病患者血压变异性与肾功能损伤关系的研究[J].临床肾脏病杂志,2016,16(2):71-75.
[21] Sulemane S,Panoulas VF,Bratsas A,et al. Subclinical markers of cardiovascular disease predict adverse outcomes in chronic kidney disease patients with normal left ventricular ejection fraction [J]. Int J Cardiovasc Imaging,2017,33(5):687-698.
[22] Zelnick LR,Katz R,Young BA,et al.Echocardiographic Measures and Estimated GFR Decline Among African Americans:the Jackson Heart Study [J]. Am J Kidney Dis,2017,1(28):3672-3679.
[23] 孔令秋,王芳,唐红,等.致心律失常性右心室心肌病合并大面积心腔内附壁血栓一例[J].中华心律失常学杂志,2015,21(6):458-459.
[24] 钟雅蓉,邵春燕,张茜,等.超声心动图综合参数在高血压患者左心室舒张功能评估中的应用[J].中国医学装备,2017,14(3):73-76.
[25] Jatene T,Castro-Filho A,Meneguz-Moreno RA,et al.Prospective comparison between three TAVR devices:ACU?鄄RATE neo vs. CoreValve vs. SAPIEN XT. A single heart team experience in patients with severe aortic stenosis [J]. Catheter Cardiovasc Interv,2016,12(28):207-212.