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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
ARTICLE HIGHLIGHTS
Research background
Echocardiography is the most-used tool for diagnosis of myocardial dysfunction. Among 2D-ecocardiography (2D-ECHO) methods, ejection fraction (EF) is the most used. In patients with myocardial dysfunction and end-stage renal disease (ESRD) parathyroid hormone (PTH) is often altered.
Research motivation
Recent echocardiography methods are being compared with ejection fraction. Global longitudinal strain (GLS) is among the most explored. Additional serum biomarkers could help to increase sensibility of tests.
Research objectives
To compare the EF and global strain methods for detecting myocardial dysfunction. To measure the potential role of some biomarkers as complementary tools in patient evaluation.
Research methods
Left ventricular systolic function (LVSF) was evaluated in 62 patients with ESRD with altered levels of PTH. LVSF was evaluated by performing 2D-ECHO, obtaining the EF, by the Simpson biplane method, and GLS by speckle tracking.
Research results
All patients with ESRD had preserved LVEF (> 50%) but abnormal GLS (< 13.55%). PTH was independently associated with lateral e' wave and tricuspid regurgitation velocity.
Research conclusions
In patients with elevated PTH and ESRD, the use of GLS by 2D-ECHO is a more-sensitive tool than LVEF for detecting myocardial dysfunction.
Research perspectives
GLS and serum PTH should be widely explored as potential sensitive tools to detect myocardial dysfunction in patients with ESRD. The mechanisms linked to this disrupted condition should be analyzed. Alternative echocardiography methods and biomarkers should be compared to select the most-sensitive and accurate tools.
