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Abstract: FR-PO1141

Left-Ventricular Hypertrophy and Diastolic Dysfunction in Korean Children with CKD: Data from the KNOW-Ped CKD Study

Session Information

  • Pediatric Nephrology - I
    October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1600 Pediatric Nephrology

Authors

  • Lee, Yeonhee, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Cho, Heeyeon, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Choi, Hyun Jin, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Kang, Hee Gyung, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Ha, IL-Soo, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Cheong, Hae Il, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Han, Kyoung Hee, Jeju National University School of Medicine, Jeju, Korea (the Republic of)
  • Kim, Seong heon, Pusan National University Children's Hospital, Yangsan, Korea (the Republic of)
  • Cho, Min Hyun, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Shin, Jae Il, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Hyun, Hyesun, St. Vincent's Hospital, The Catholic University College of Medicine, Suwon, Korea (the Republic of)
  • Lee, Joo Hoon, Asan Medical Center, Seoul, Korea (the Republic of)
  • Park, Young seo, Asan Medical Center, Seoul, Korea (the Republic of)
Background

Left-ventricular (LV) hypertrophy (LVH) and LV diastolic dysfunction are early marker of cardiovascular disease in pediatric chronic kidney disease (CKD), and the early detection of LVH is important to prevent morbidity and mortality in children with CKD. However, there is no consensus on the ideal method of defining LVH in pediatric CKD patients. The aim of this study was to evaluate the LVH measurement methods and the association the presence of LVH and LV diastolic dysfunction in Korean children with CKD.

Methods

We used the baseline data of the KoreaN cohort study for Outcome in patients With Pediatric Chronic Kidney Disease (KNOW-Ped CKD), a nationwide, 10-year, prospective, observational cohort study of pediatric CKD. A total 310 patients were included in the final analysis.

Results

The mean age of the patients was 10.3±5.2 years, and male to female ratio was 2.2:1. The mean value of LV mass index (LVMI) was 38.3g/m2.7. The mean ejection fraction and fractional shortening was 66.8 and 36.6%, respectively. According to an LVH diagnosis by LVMI ≥ 38.6 g/m2.7, 128 patients (41.3 %) were diagnosed with LVH. Using the z-score > 1.64 reference values, 19 patients (6.1 %) were diagnosed with LVH. According to the ratio of early/late diastolic myocardial velocity (E/A ratio < 0.9 or > 2.0), 101 patients (32.5 %) had diastolic dysfunction. Sixteen patients (6.4 %) were diagnosed as having diastolic dysfunction by mitral peak velocity of early filling to early diastolic mitral annular velocity (E/E’ ratio > 15). Kappa coefficient showed a significant value of 0.076 between LVH by LVMI >38.6g/m2.7 and diastolic dysfunction by E/E’ ratio > 15. LVMI calculation for predicting E / E '> 15 by Youden's index method is 32.1g/m2.7

Conclusion

The study suggests that the definition of LVH by LVMI ≥ 38.6 g/m2.7could be more associated with diastolic dysfunction according to E/E’ > 15. Further investigation to find a better method of defining LVH to predict cardiac dysfunction in the children with CKD is necessary.

Funding

  • Government Support - Non-U.S.