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Diastolic dysfunction measured by tissue Doppler imaging in children with end-stage renal disease: a report of the RICH-Q study

Published online by Cambridge University Press:  05 March 2013

Nikki J. Schoenmaker ,
Irene M. Kuipers ,
Johanna H. van der Lee ,
Wilma F. Tromp ,
Maria van Dyck ,
Marc Gewillig ,
Nico A. Blom  and
Jaap W. Groothoff
Nikki J. Schoenmaker*
Affiliation:
Department of Paediatric Nephrology, Emma Children's Hospital AMC Amsterdam, The Netherlands
Irene M. Kuipers
Affiliation:
Department of Paediatric Cardiology, Emma Children's Hospital AMC Amsterdam, The Netherlands
Johanna H. van der Lee
Affiliation:
Department of Paediatric Clinical Epidemiology, Emma Children's Hospital AMC Amsterdam, The Netherlands
Wilma F. Tromp
Affiliation:
Department of Paediatric Nephrology, Emma Children's Hospital AMC Amsterdam, The Netherlands
Maria van Dyck
Affiliation:
Department of Paediatric Nephrology, University Hospital Leuven, Belgium
Marc Gewillig
Affiliation:
Department of Paediatric Cardiology, University Hospital Leuven, Belgium
Nico A. Blom
Affiliation:
Department of Paediatric Cardiology, Emma Children's Hospital AMC Amsterdam, The Netherlands
Jaap W. Groothoff
Affiliation:
Department of Paediatric Nephrology, Emma Children's Hospital AMC Amsterdam, The Netherlands
*
Correspondence to: Dr N.J. Schoenmaker MD, PhD student, Academic Medical Centre, Dialysis department, A01.247. Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Tel: 0031205666152; Fax: 0031205669202; E-mail: N.J. Schoenmaker@amc.nl
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Abstract

Introduction: Early detection of cardiovascular disease in children with end-stage renal disease is essential in order to prevent cardiovascular morbidity and mortality in early adulthood. Tissue Doppler imaging has shown to be a promising method to detect and quantify subtle abnormalities in diastolic function. We therefore compared assessment of diastolic function by conventional echocardiography and tissue Doppler imaging. Methods: We performed conventional echocardiography and tissue Doppler imaging in 38 children with end-stage renal disease and 76 healthy controls. We compared outcomes on parameters related to diastolic function (E/a ratio for conventional echocardiography and E/E′ ratio for tissue Doppler imaging) for both groups using multiple linear regression analysis. Diastolic dysfunction was defined as E/a ratio <1 or E/E′ ratio > 95th percentile for age. To assess the intra-observer reproducibility, the coefficient of variation was calculated. Results: Children with end-stage renal disease had on average a lower E/a ratio (p = 0.004) and a higher mitral and septal E/E′ ratio (both p < 0.001) compared with controls. In all, two children with end-stage renal disease (5%) had diastolic dysfunction according to the E/a ratio, 11 according to the mitral E/E′ ratio (29%), and 16 according to the septal E/E′ ratio (42%) compared with none of the controls (p = 0.109, p < 0.001, and p < 0.001, respectively). The coefficients of variation of the mitral (7%) and septal E/E′ ratio (4%) were smaller than the coefficient of variation of the E/a ratio (11%). Conclusions: Tissue Doppler imaging is a more sensitive and reliable method to detect diastolic dysfunction than conventional E/a ratio in children with end-stage renal disease.

Keywords

Paediatric cardiologyend-stage renal diseasecardiovascular diseaseimagingdiastolic dysfunctionintra-observer reproducibility
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 2 , April 2014 , pp. 236 - 244
Copyright
Copyright © Cambridge University Press 2013 

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