Subclinical myocardial disease in patients with primary hyperoxaluria and preserved left ventricular ejection fraction: a two-dimensional speckle-tracking imaging study

Background Primary hyperoxaluria (PH) is characterized by progressive chronic kidney disease (CKD) and systemic oxalate deposition. Myocardial dysfunction might be present early in the course of the disease. However, this hypothesis has not yet been tested in the PH population. Therefore, we aimed t...

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Published in:Pediatric nephrology (Berlin, West) West), 2019-12, Vol.34 (12), p.2591-2600
Main Authors: Lagies, Ruth, Udink ten Cate, Floris E. A., Feldkötter, Markus, Beck, Bodo B., Sreeram, Narayanswami, Hoppe, Bernd, Herberg, Ulrike
Format: Article
Language:English
Subjects:
Blood pressure
Cardiomyopathy
Care and treatment
Coronary artery disease
Creatinine
Diagnosis
Echocardiography
Ejection fraction
Heart diseases
Heart ventricle, Left
Hyperoxaluria
Kidney diseases
Medical examination
Medicine
Medicine & Public Health
Nephrology
Original Article
Oxalic acid
Oxalosis
Oxaluria
Pediatrics
Primary hyperoxaluria
Renal function
Urology
Ventricle
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Summary:Background Primary hyperoxaluria (PH) is characterized by progressive chronic kidney disease (CKD) and systemic oxalate deposition. Myocardial dysfunction might be present early in the course of the disease. However, this hypothesis has not yet been tested in the PH population. Therefore, we aimed to determine whether strain imaging using two-dimensional speckle tracking echocardiography (2D-STE) might detect subclinical myocardial disease in otherwise asymptomatic PH patients. Methods Prospective study of pediatric and adolescent PH patients with preserved LV ejection fraction (LV EF) and without renal replacement therapy. Subjects underwent conventional echocardiography and 2D-STE. Global (GLS) and segmental peak systolic LV longitudinal strain (LS) measurements were obtained. Data were compared with age- and gender-matched controls, and Z-scores were calculated as appropriate. Results Fifteen PH patients (age 14.1 ± 5.9 years; 13/15 in CKD stages 1–2) were studied. Although LV EF was preserved (63 ± 6%) in patients, GLS was significantly impaired (GLS − 17.1 ± 2.2% vs − 22.4 ± 1.9%, p  
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-019-04330-7