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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Global longitudinal strain is superior to ejection fraction for detecting myocardial dysfunction in end-stage renal disease with hyperparathyroidism
Maria Fernanda Carrasco-Ruiz, Antonio Ruiz-Rivera, Marvin A Soriano-Ursúa, Carlos Martinez-Hernandez, Leticia Manuel-Apolinar, Carmen Castillo-Hernandez, Gustavo Guevara-Balcazar, Eunice D Farfán-García, Ana Mejia-Ruiz, Ivan Rubio-Gayosso, Teresa Perez-Capistran
Maria Fernanda Carrasco-Ruiz, Marvin A Soriano-Ursúa, Teresa Perez-Capistran, Department of Physiology, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
Antonio Ruiz-Rivera, Carlos Martinez-Hernandez, Department of Cardiology, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
Leticia Manuel-Apolinar, Endocrine Research Unit, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
Carmen Castillo-Hernandez, Gustavo Guevara-Balcazar, Department of Cardiovascular Pharmacology, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
Eunice D Farfán-García, Department of Biochemistry, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
Ana Mejia-Ruiz, Education Research, Comisión Nacional Para la Mejora Continua de la Educación, Ciudad de México 03900, Mexico
Ivan Rubio-Gayosso, Postgraduate Studies and Research Section,Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
Teresa Perez-Capistran, Department of Physiology, Instituto Politécnico Nacional, Mexico City 11340, Ciudad de México, Mexico
Author contributions: Carrasco-Ruiz MF, Ruiz-Rivera A, and Perez-Capistran T conceptualized the study; Ruiz-Rivera A, Martinez-Hernandez CM and Manuel-Apolinar L done data collection; Carrasco-Ruiz MF, Ruiz-Rivera A, Mejia-Ruiz A, Soriano-Ursúa MA and Martinez-Hernandez C carried out data analysis and interpretation; Carrasco-Ruiz MF, Soriano-Ursúa MA, and Perez-Capistran T drafting article; and All authors revised and approved the final version of this manuscript.
Supported by the Secretaría de Investigación y Posgrado of the Instituto Politécnico Nacional; the Comisión de Operación y Fomento de Actividades Académicas of the Instituto Politécnico Nacional; and the Consejo Nacional de Ciencia y Tecnología.
Institutional review board statement: The study was approved by Comité de Ética del Centro Médico Nacional, Siglo XXI, IMSS, México.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors here declare no conflicts of interests or relationships regarding the industry at the date of this submission.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Teresa Perez-Capistran, PhD, Academic Research, Department of Physiology, Instituto Politécnico Nacional, Plan de San Luis y Diaz Miron s/n Col. Casco de Sto Tomas, Mexico City 11340, Ciudad de México, Mexico. ruper-05@hotmail.com
Received: November 17, 2021
Peer-review started: November 17, 2021
First decision: December 27, 2021
Revised: January 7, 2022
Accepted: April 4, 2022
Article in press: April 4, 2022
Published online: April 26, 2022
BACKGROUND
The estimation of left ventricular ejection fraction (LVEF) by 2D echocardiography (2D-ECHO) is the most used tool to assess LV systolic function (LVSF). Global longitudinal strain (GLS) has recently been suggested as a superior method for several evaluations. This study explored the association and prevalence of LV systolic dysfunction (LVSD) by using these methods in patients with end-stage renal disease (ESRD) and severe hyperparathyroidism (SHPTH); both associated with cardiovascular events (CEs).
AIM
To evaluate the myocardial function in patients with ESRD and SHPTH by using the GLS and LVEF measured through conventional 2D-ECHO.
METHODS
In 62 patients with ESRD and SHPTH, asymptomatic, and without a history of CEs, LVSF was evaluated by 2D-ECHO, obtaining the EF, by the Simpson biplane method, and GLS by speckle tracking.
RESULTS
The total patients with ESRD had a preserved LVEF (> 50%) but abnormal GLS (< 13.55%). Additionally, multivariate analysis showed an independent association of GLS and serum parathyroid hormone (PTH), LV mass index, and hemoglobin. Also, PTH was independently associated with lateral e' wave and tricuspid regurgitation velocity.
CONCLUSION
In patients with SHPTH linked to ESRD, the use of GLS by 2D-ECHO is a more sensitive tool than LVEF for detecting LVSD.
Core Tip: This study compared global longitudinal strain (GLS) with the often-used left ventricular ejection fraction to estimate ventricular dysfunction in patients with end-stage renal disease. GLS had an advantage to detect dysfunction, but also, it was found that the parathyroid hormone levels were attractive as a complementary tool to predict patient status.
