Left Ventricular Global Longitudinal Strain and H2FPEF Score in Chronic Kidney Disease Patients with Preserved Left Ventricular Ejection Fraction

Abstract Background Cardiovascular disease is the leading cause of mortality in patients with chronic kidney disease (CKD). Although they have mostly normal left ventricular systolic functions using conventional echocardiography some of them develop symptoms of heart failure with preserved ejection fraction (HFpEF) (Dubin et al, 2017), (Edwards et al, 2008). Objective This study aims to assess left ventricular global longitudinal strain and H2FPEF score in chronic kidney disease patients with preserved left ventricular ejection fraction. Patients and Methods The current study was a prospective study that included a total of 100 patients who were referred to our center (Ain Shams University Hospitals) nephrology clinic. Data was collected on patient arrival to our hospital and then echocardiography including LVGLS was done to all patients. All clinical and echocardiographic data were utilized do assess HfPEF probability using H2FPEF score. Results The mean age of our patients was 43.2±15.7 years and 58% of the patients were men. Ninety- five % of patients were hypertensives with more than 94 % receiving two or more anti-hypertensive medications while atrial fibrillation was found in 30% of the patients. Dialysis patients (stage Vd CKD) represented 52% of patients while stage III CKD represented 43% of patients. The patients’ hemoglobin ranged from 9-13.5 gm/dl with mean 10.415 ± 1.259. According to H2FPEF score, 29 (29%) patients had high probability to have HFpEF. Left ventricular Global longitudinal strain (GLS) in 54 patients was less negative than -16 (65.85%). Global longitudinal strain GLS showed positive correlation with H2FPEF score r = 0.406, P-value <0.001. Figure 1 Conclusion Chronic kidney disease is strongly associated with reduced global longitudinal strain and with high probability of HFPEF.