The following is a summary of “Myocardial work in chronic kidney disease: insights from the CPH-CKD ECHO Study,” published in the May 2024 issue of Cardiology by Olsen et al.

Myocardial work, a new echocardiographic measure, provides detailed insights into heart mechanics.

Researchers conducted a prospective study to understand cardiac function using myocardial work in patients with chronic kidney disease (CKD).

They enrolled 757 patients in non-dialysis-dependent CKD and 174 matched controls. Echocardiographic pressure-strain loop analysis measured the global work index (GWI). The linear regression model explored the relationship between estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) to GWI.

The results showed that in patients with CKD (mean age 57 years, 61% men, median eGFR 42mL/min/1.73m²), overall GWI was similar to controls (1879 vs. 1973 mmHG%, P=0.06). However, GWI declined stepwise: controls > CKD without left ventricular hypertrophy (LVH) > CKD with LVH (GWI, 1943 vs. 1887 vs. 1789 mmHg%, P for trend = 0.030). In patients with CKD, eGFR wasn’t linked to GWI by linear regression, but diabetes modified this (P for interaction = 0.007), observing 10mL/min/1.73 m², and GWI decrease by 22 (9-35) mmHg% (P=0.001) after adjustments in patients without diabetes, but no association was found between other groups.

Investigators concluded that patients with CKD with LVH had reduced myocardial work compared to controls. Decreasing eGFR was related to lower myocardial work in patients with non-diabetic CKD. No association was found with UACR levels.

Source: link.springer.com/article/10.1007/s00392-024-02459-6