Abstract: TH-PO606
Effect of a 3-Year Lifestyle Intervention on Cardiac Parameters in People With CKD: Sub-Study of a Randomized Controlled Trial
Session Information
- Hypertension and CVD: Epidemiology, Risk Factors, Prevention
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1502 Hypertension and CVD: Clinical‚ Outcomes‚ and Trials
Authors
- Jegatheesan, Dev Krish, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Krishnasamy, Rathika, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
- Stanton, Tony, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
- Isbel, Nicole, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Howden, Erin, The University of Queensland, Saint Lucia, Queensland, Australia
- Beetham, Kassia S., The University of Queensland, Saint Lucia, Queensland, Australia
- Coombes, Jeff S., The University of Queensland, Saint Lucia, Queensland, Australia
Group or Team Name
- LANDMARK III Investigators
Background
Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular (CV) disease and mortality. We report the transthoracic echocardiogram (TTE) findings of a predefined sub-study of the LANDMARK III trial, which compared the effect of a nurse-led model of care on CV risk factor modification.
Methods
Adult patients with moderate CKD were randomized to either usual care (UC) or to the nurse-led multidisciplinary lifestyle intervention (LI) in addition to UC. The intervention group received lifestyle and medication advice (from nurse, exercise physiologist, dietitian, psychologist, diabetes educator and social worker) to ensure attainment of risk factor targets; undertook an 8-week supervised exercise training program and a 4-week behavioural modification program focusing on sustainable and self-manageable lifestyle goals. Patients were followed up for 3 years with TTE performed at baseline and annually.
Results
A total of 162 patients were randomized and 56% were male. Mean age was 60 ± 10 years, eGFR was 40 ± 9 ml/min/1.73m2, ejection fraction (EF) was 66 ± 7% and global longitudinal strain (GLS) was 18.3 ± 4%. A significant between group difference in GLS (p < 0.001) was identified over the study period, with a significantly greater decline in GLS in the UC group and preservation of GLS in the LI group (-1.1% vs -0.4%, UC vs LI). No significant changes in EF, left ventricular (LV) mass index, LV filling pressure fractional shortening or relative wall thickness were noted between groups.
Conclusion
A 3-year multidisciplinary LI in people with CKD preserved LV systolic function (GLS) compared to the UC group, who experienced a significant decline in GLS over the study period. This study further highlights that GLS may be a more sensitive marker of LV systolic function than EF in people with CKD.