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Left Atrial Strain Is the Best Predictor of Adverse Cardiovascular Outcomes in Patients with Chronic Kidney Disease

Authors:	Gary CH Gan Krishna K Kadappu Aditya Bhat Fernando Fernandez Kennith H Gu Lawrence Cai Karen Byth Suzanne Eshoo Liza Thomas

Institution:	1. Department of Cardiology, Blacktown Hospital, Sydney, New South Wales, Australia;2. Department of Cardiology, Liverpool Hospital, Sydney, New South Wales, Australia;3. Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia;4. Department of Cardiology, Campbelltown Hospital, Sydney, New South Wales, Australia;5. University of New South Wales, Sydney, New South Wales, Australia;6. Biostatistics Unit, Research and Education Network, Westmead Hospital, and the University of Sydney, Sydney, New South Wales, Australia;7. Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia;1. Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan;2. Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan;3. Department of Internal Medicine, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan;4. Section of Cardiology, Department of Internal Medicine, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan;5. Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan;6. Division of Cardiology, Department of Internal Medicine, University of North Carolina Medical Center, Chapel Hill, North Carolina;7. Section of Cardiology, Department of Internal Medicine, UChicago Medicine, Chicago, Illinois;8. Department of Cardiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California;9. Spectrum Health Cardiovascular Medicine, Grand Rapids, Michigan

Abstract:	Patients with stage 3 and stage 4 CKD demonstrate alterations in LV GLS, LVMI, E/e′, LAVI, and LASr but had normal LVEF. Each of these parameters was evaluated using reported normal values as a cutoff (normal indicated as green) in the figure. Left atrial reservoir strain was the strongest predictor of death and MACE and the only echocardiographic parameter that predicted adverse events. Download : Download high-res image (243KB) Download : Download full-size image

Keywords:	Left atrial strain Left atrial function Chronic kidney disease 2D speckle-tracking echocardiography LA GLS 2D"} {"#name":"keyword" "$":{"id":"kwrd0040"} "$$":[{"#name":"text" "_":"Two-dimensional ACEi"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"Angiotensin converting enzyme inhibitors ARB"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"Angiotensin receptor blocker ASCVD"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"Atherosclerotic Cardiovascular Disease risk score AUC"} {"#name":"keyword" "$":{"id":"kwrd0080"} "$$":[{"#name":"text" "_":"Area under the curve CKD"} {"#name":"keyword" "$":{"id":"kwrd0090"} "$$":[{"#name":"text" "_":"Chronic kidney disease CVD"} {"#name":"keyword" "$":{"id":"kwrd0100"} "$$":[{"#name":"text" "_":"Cardiovascular disease eGFR"} {"#name":"keyword" "$":{"id":"kwrd0110"} "$$":[{"#name":"text" "_":"Estimated glomerular filtration rate FRS"} {"#name":"keyword" "$":{"id":"kwrd0120"} "$$":[{"#name":"text" "_":"Framingham 10-year absolute CVD risk score HR"} {"#name":"keyword" "$":{"id":"kwrd0130"} "$$":[{"#name":"text" "_":"Hazard ratio LA"} {"#name":"keyword" "$":{"id":"kwrd0140"} "$$":[{"#name":"text" "_":"Left atrial atrium LAEF"} {"#name":"keyword" "$":{"id":"kwrd0150"} "$$":[{"#name":"text" "_":"Left atrial ejection fraction LAScd"} {"#name":"keyword" "$":{"id":"kwrd0160"} "$$":[{"#name":"text" "_":"Left atrial conduit strain LASct"} {"#name":"keyword" "$":{"id":"kwrd0170"} "$$":[{"#name":"text" "_":"Left atrial contractile strain LASr"} {"#name":"keyword" "$":{"id":"kwrd0180"} "$$":[{"#name":"text" "_":"Left atrial reservoir strain LAVI"} {"#name":"keyword" "$":{"id":"kwrd0190"} "$$":[{"#name":"text" "_":"Left atrial volume indexed LV"} {"#name":"keyword" "$":{"id":"kwrd0200"} "$$":[{"#name":"text" "_":"Left ventricular ventricle LVEF"} {"#name":"keyword" "$":{"id":"kwrd0210"} "$$":[{"#name":"text" "_":"Left ventricular ejection fraction LV GLS"} {"#name":"keyword" "$":{"id":"kwrd0220"} "$$":[{"#name":"text" "_":"Left ventricular global longitudinal strain LVMI"} {"#name":"keyword" "$":{"id":"kwrd0230"} "$$":[{"#name":"text" "_":"Left ventricular mass indexed MACE"} {"#name":"keyword" "$":{"id":"kwrd0240"} "$$":[{"#name":"text" "_":"Major adverse cardiovascular event RAAS"} {"#name":"keyword" "$":{"id":"kwrd0250"} "$$":[{"#name":"text" "_":"Renin-angiotensin-aldosterone system ROC"} {"#name":"keyword" "$":{"id":"kwrd0260"} "$$":[{"#name":"text" "_":"Receiver operating characteristic
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