BACKGROUND Left ventricular global longitudinal strain (LV GLS) on echocardiography is a sensitive yet clinically significant marker of myocardial dysfunction. Reduced LV GLS is prevalent in adults with chronic kidney disease and hypertension and is associated with adverse cardiovascular outcomes. It may be a biomarker of chronic kidney disease-associated myocardial dysfunction in children, but data are limited. Our objective was to describe LV GLS in the CKiD study (Chronic Kidney Disease in Children) and to examine the association between blood pressure (BP) and reduced LV GLS. METHODS A single apical 4-chamber view was used to estimate LV GLS. Our main analyses examined the association of clinic BP with the absolute value of LV GLS and LV GLS dichotomized at 16. Sensitivity analyses using 24-hour ambulatory BP monitoring data were also performed. Generalized estimating equations were used to account for within-person correlation and to estimate robust SEs for 95% CIs. Covariates in adjusted models included: age, sex, race, estimated glomerular filtration rate, urine protein, hemoglobin, left ventricular hypertrophy, and the use of renin-angiotensin system inhibitors. RESULTS LV GLS was measured in 962 person-visits. A total of 77 assessments had an LV GLS <16. In adjusted models, both clinic systolic BP (odds ratio, 1.02 [95% CI, 1.01-1.03]) and diastolic BP (odds ratio, 1.02 [95% CI, 1.00-1.03]) percentiles were associated with LV GLS <16. Having awake or nighttime diastolic BP hypertension on ambulatory BP monitoring was significantly associated with a lower absolute value of LV GLS. CONCLUSIONS Office systolic and diastolic hypertension was associated with diminished LV GLS. Only diastolic hypertension detected on ambulatory BP monitoring was associated with lower LV GLS.

中文翻译：

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小儿慢性肾病中的高血压和左心室劳损。


背景 超声心动图上的左心室整体纵向应变 （LV GLS） 是心肌功能障碍的敏感但具有临床意义的标志物。LV GLS 降低在患有慢性肾病和高血压的成人中普遍存在，并且与不良心血管结局相关。它可能是儿童慢性肾病相关心肌功能障碍的生物标志物，但数据有限。我们的目的是描述 CKiD 研究 （儿童慢性肾脏病） 中的 LV GLS，并检查血压 （BP） 与 LV GLS 降低之间的关联。方法 使用单个根尖 4 腔视图估计 LV GLS。我们的主要分析检查了临床血压与 LV GLS 绝对值和 16 二分 LV GLS 的相关性。还使用 24 小时动态血压监测数据进行了敏感性分析。广义估计方程用于解释人内相关性并估计 95% CI 的稳健 SE。调整模型中的协变量包括：年龄、性别、种族、估计的肾小球滤过率、尿蛋白、血红蛋白、左心室肥大和肾素-血管紧张素系统抑制剂的使用。结果 在 962 次就诊中测量了 LV GLS。共有 77 项评估的 LV GLS <16。在调整后的模型中，临床收缩压 （比值比，1.02 [95% CI，1.01-1.03]）和舒张压 （比值比，1.02 [95% CI，1.00-1.03]）百分位数均与 LV GLS <16 相关。动态血压监测显示清醒或夜间舒张压高血压与 LV GLS 绝对值降低显著相关。结论 诊室收缩压和舒张压与 LV GLS 降低相关。 仅在动态血压监测中检测到舒张期高血压与较低的 LV GLS 相关。