Abstracts of medical phd thesis: research on myocardial defprmation by speckle tracking echocardiography in patients with chronic kidney disease

MINISTRY OF EDUCATION AND TRAINING MINISTRY OF DEFENCE 108 INSTITUTE OFCLINICAL MEDICAL AND PHARMACEUTICAL SCIENCE =======***======= NGUYEN DINH CHUC RESEARCH ON MYOCARDIAL DEFPRMATION BY SPECKLE TRACKING ECHOCARDIOGRAPHY IN PATIENTS WITH CHRONIC KIDNEY DISEASE Spe ciality: Cardiology Code : 62.72.01.41 ABSTRAC TS O F MEDICAL PHD THESIS HA NO I - 2021 This Thesis was done in 108 Institute of Clinical Me dical and Pharmaceutical Sciences Supe rvisor: Ass Prof PhD Pham T hai Giang Ass Prof PhD Pham Nguyen Son Re viewe r: ………………………… …………………………… …………………………… This thesis will be presented at institute council at institute of clinical medical and pharmaceutical sciences Day Month Year The thesis can be found at: Nat ional Library of Vietnam Library of Institute of Clinical Medical and Pharmaceutical Sciences Central Institute for Medical Sciences Information and T echnology INTRO DUCTIO N Chronic kidney disease (CKD) is a disease with many complications involving many different organ systems, depending on the stage of chronic kidney disease, the complications encountered can vary in number as well as level severity of the disease Anemia, bone and mineral metabolism disorders, peripheral vascular disease, neurological disease, mental disorders, especially cardiovascular complications are common complications in patients with CKD In the world, there are echocardiography to many authors assess heart using function speckle in tracking patients with hypertension, diabetes and other diseases and are used in patients Chronic kidney disease with and without dialysis, of particular significance in patients with normal left ventricular ejection fraction In Vietnam, there are no works using speckle tracking echocardiography in patients with chronic kidney disease From the above reasons, we carried out the project "Research on Myocardial deformation by spe ckle tracking e chocardiography in patients with chronic kidney disease" with two objects: 1- Survey on the clinical, subclinical and myocardial deformation in chronic kidney patients with a normal left ventricular ejection fraction 2- Investigate the relationship between the parameters of speckle tracking echocardiographic with some clinical and subclinical features in patients with chronic kidney disease with a normal left ventricular ejection fraction TH E N EW CONTRIBU TIO NS O F TH E TH ESIS This is the first study in Vietnam with a large number of study subject s, using speckle t racking echocardiography to evaluate in detail left ventricular function along the longitudinal, radial and circumference direction as well as left ventricular rotation, twist, and untwist in chronic kidney disease with normal left ventricular ejection fraction Myocardial deformation: GLS decreased 37.9%, MSP decreased: 16.3%, GLSRe decreased: 13.7%, MDP decreased: 11.1% The rotation and twist of left ventricular increased more than the control group without any difference The systolic and diastolic parameters decrease with the grade of disease, positively correlated with the GFR CKD with increased blood pressure, diabetes with decreased deformation index, the rate of impaired systolic function, diastolic increased more in the group of chronic kidney disease without diabetes, increased blood pressure CKD with left ventricular hypertrophy: Myocardial deformation index decreases, the rate of systolic and diastolic dysfunct ion increases Multivariable analysise: Hypertension is an independent predictor of decreased systolic and diastolic function in the stages of CKD Research results show that in chronic kidney patients with a normal left ventricular ejection fraction, there is a decrease in both systolic and diastolic function Although the rate of reduction is not high, it is an early change This is the meaningful contribution of the topic to the major TH E LAYO UT O F TH E TH ESIS The thesis with 136 pages including: Introduction (2 pages), literature review (34 pages), material and methods (27 pages), results (36 pages), discussion (34 pages), conclusion (2 pages), request (1 page) T he thesis has 41 tables, charts, 12 pictures, diagrams Using 174 references including 20 documents in Vietnamese, 154 documents in English Chapte r LITERA TUR E R EVIEW 1.1 Chronic kidney disease 1.1.1 Conce pts and te rminology Chronic Kidney Disease (CKD): In 2002, the American Nat ional Nephrology Association and the Kidney Disease Consequence Assessment Council (NKF / KDOQI) released the first practical guidance on chronic kidney disease By 2012, the International Nephrology Associat ion (ISN) issued guidance from the Global Kidney Disease Consequence Improvement Group (KDIGO) that complements the 2002 Renal Disease Practice Guidelines is defined as having one of the following standards: (1) Renal damage lasting for ≥ months leads to changes in kidney structure and function These disorders may or may not reduce glomerular filtration rate (GFR), manifest in histopathological lesions, changes in blood chemistry, urine or renal morphology through diagnostic imaging (2) Glomerular Filtration Rate (GFR) decreased by 13 1,355 0,478 – 3,843 > 0,05 e’ (septum) < 1,953 0,693 – 5,505 > 0,05 Hypertension pulmonary artery 3,125 1,236 – 7,903 < 0,05 Comment: Age, GFR, hypertension, Hypertension pulmonary artery are independent risk factors for decreased MSP Table 3.40 Logistic re gression of MDP re duction risk factors Factors Odds ratio (OR) CI 95% p Hypertension 1,706 0,702 – 4,144 > 0,05 e' (septum) < 2,142 0,837 – 5,482 > 0,05 Age > 60 0,731 0,3 – 1,78 > 0,05 BMI > 23 0,453 0,144 – 1,426 > 0,05 Left atral dilatation 2,763 1,222 – 6,247 < 0,05 Comment: Left atrial dilatation is an independent risk factor for decreased MDP Table 3.41 Logistic regression of MSP and MDP reduction risk factors ... function speckle in tracking patients with hypertension, diabetes and other diseases and are used in patients Chronic kidney disease with and without dialysis, of particular significance in patients. .. project "Research on Myocardial deformation by spe ckle tracking e chocardiography in patients with chronic kidney disease" with two objects: 1- Survey on the clinical, subclinical and myocardial. .. patients with normal left ventricular ejection fraction In Vietnam, there are no works using speckle tracking echocardiography in patients with chronic kidney disease From the above reasons, we