الفهرس 
LA FunctionOnly 14 pages are availabe for public view
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Abstract
Summary
Cardiovascular mortality and morbidities are high in CKD, and the
presence of CKD worsens outcomes of cardiovascular disease (CVD). (5)
LA function is normally in a close interdependence with LV
function, and it plays a key role in maintaining an optimal cardiac performance. The LA modulates LV filling through its reservoir, conduit and systolic pump function, whereas LV function influences LA function
throughout the cardiac cycle. (11)
Strain imaging provide data on myocardial deformation by estimating spatial gradients in myocardial velocities. As opposed to color
TDI, this technique is relatively unaffected by heart motion and
contraction of adjacent segments.(30,73,79,81, 82) LA volume measurement is now considered superior to LA
diameter, and in the general population, larger LA volume has been
associated with atrial fibrillation, stroke, congestive heart failure , and
mortality In a healthy individual, LA size and volume correlate with the
body habitus. In measuring LA size, it is important to adjust for the body surface area (BSA) in order to compensate for gender as well as racial and
ethnic differences between individuals. (104,105,106,107)
LA volume indexed for body surface area (LAVi) is the most accurate measure of LA size obtainable by standard echocardiography. (8)
So, this study aimed to investigate the value of left atrial volume and strain analysis in the detection of myocardial involvement in early CKD.This study included 30 patients with CKD referred to cardiology department Tanta University for routine evaluation, and 30 healthy subjects as control group.
All participants were subjected to detailed history taking with full
clinical examination, laboratory investigation and non-invasive evaluation
including resting 12 leads ECG and Echocardiographic assessment of LV
systolic function, LV diastolic function, left ventricular mass indexed to
body surface area.
Furthermore LA volume indexed (LAVi) for body surface area was measured using Biplane Area-Length Method in apical-four and two
chamber and finally left atrial wall deformation was assessed using systolic strain (S) measurement which was obtained using color- coded
TDI at the mid segment of LA septal, lateral, anterior and inferior walls.
The present study results revealed that there was no statistically significant difference between the two groups regarding age and sex, but
there was statistically significant difference between the two groups as
regard BMI.
There was statistically high significant difference between control
and CKD groups regarding LVMI, CKD group had larger LVMI than
control group.
Regarding LV systolic function, there was no statistically significant difference between control and CKD groups, LVEF was within
the normal range in the two groups.
Regarding LV diastolic function, there was statistically significant
difference between control and CKD groups regarding E/A ratio, there was statistically high significant difference between control and CKD groups regarding e` and there was statistically high significant difference between control and CKD groups regarding E/e` ratio. As a result, there was LV diastolic dysfunction in 20% of control group, while in 87% in
CKD group, and stage 3 CKD had the most reduced diastolic function.
There was statistically high significant difference between control
and CKD groups regarding LAVi, LA volume was normal in control
group while it was increased in CKD patients, Stage 3 CKD had severely increased LA volume than stage 1 and 2 CKD.
In the present study, LA wall systolic strain (S) measures show
statistically high significant difference between the two groups. LA wall systolic strain (S) values were decreased in CKD group compared to
control group, and we concluded that LA systolic strain was more reduced
in stage 3 CKD than stages 1 and 2 CKD.