{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:53:46Z","timestamp":1783407226915,"version":"3.54.6"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,1,22]],"date-time":"2014-01-22T00:00:00Z","timestamp":1390348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2014,9]]},"abstract":"Background<\/jats:title>Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality; hence detection of early cardiovascular involvement in CKD is important to prevent future adverse cardiovascular events. Left atrial (LA) enlargement and dysfunction has been reported in end stage renal disease. However, there is a paucity of published data regarding the evaluation of LA function in CKD using noninvasive imaging parameters. In this study, we evaluated biplane LA volume as well as LA function (LA global systolic strain (GS) and strain rate [SR]) in stage 3 CKD patients (eGFR<\/jats:styled-content> 30\u201359\u00a0mL\/min per 1.73\u00a0m2<\/jats:sup>) to determine if LA function parameters are more significantly altered by the presence of CKD in addition to changes due to hypertension alone.<\/jats:p><\/jats:sec>Methods<\/jats:title>Thirty\u2010three CKD patients (eGFR<\/jats:styled-content> 30\u201359\u00a0mL\/min per 1.73\u00a0m2<\/jats:sup>) with hypertension were compared to 33 normal controls and 34 hypertensive (HT) subjects with normal renal function; all participants underwent a detailed transthoracic echocardiogram. Indexed biplane LA volume (LAVI), LA segmental function, and GS and SR (systolic, early, and late diastole) derived from tissue Doppler imaging (TDI) were measured. Univariate predictors of LA strain were determined. Multiple logistic regression analysis was used to examine the effect of patient group (i.e. CKD) on GS and SR as well as LAVI.<\/jats:p><\/jats:sec>Results<\/jats:title>Left atrial volume indexed was significantly increased in both the HT<\/jats:styled-content> and CKD<\/jats:styled-content> with HT<\/jats:styled-content> group compared to normal controls (28\u00a0\u00b1\u00a09\u00a0mL\/m2<\/jats:sup> vs. 28\u00a0\u00b1\u00a09\u00a0mL\/m2<\/jats:sup> vs. 23\u00a0\u00b1\u00a05\u00a0mL\/m2<\/jats:sup>, respectively, P\u00a0=\u00a00.02). However, LAVI<\/jats:styled-content> was similar in the HT<\/jats:styled-content> and CKD<\/jats:styled-content> with HT<\/jats:styled-content> group (28\u00a0\u00b1\u00a09\u00a0mL\/m2<\/jats:sup> vs. 28\u00a0\u00b1\u00a09\u00a0mL\/m2<\/jats:sup>; P\u00a0=\u00a0NS). LA GS<\/jats:styled-content> and SR<\/jats:styled-content> were reduced in both the CKD<\/jats:styled-content> with HT<\/jats:styled-content> and HT<\/jats:styled-content> group, compared to controls. However, a significantly lower LA GS<\/jats:styled-content> was present in the CKD<\/jats:styled-content> with HT<\/jats:styled-content> group (Controls vs. HT<\/jats:styled-content> vs. CKD<\/jats:styled-content> with HT<\/jats:styled-content>: 54.9\u00a0\u00b1\u00a014.5% vs. 34.5\u00a0\u00b1\u00a06.2% vs. 25.7\u00a0\u00b1\u00a09.3%, respectively; P\u00a0=\u00a00.001). To examine the effect of group, (i.e. presence of CKD<\/jats:styled-content>) multiple logistic regression analysis was performed with univariate predictors including indexed left ventricular mass (LVMI<\/jats:styled-content>), LV<\/jats:styled-content> diastolic grade, LAVI<\/jats:styled-content>, peak A\u2010wave velocity, \u03b2\u2010blocker therapy, GS<\/jats:styled-content> and SR<\/jats:styled-content>; this demonstrated that CKD<\/jats:styled-content> had an independent effect on LA GS<\/jats:styled-content> and SR<\/jats:styled-content> (systolic, early, and late diastole). GS<\/jats:styled-content> demonstrated moderate correlation with systolic blood pressure (r\u00a0=\u00a0\u22120.5, P\u00a0=\u00a00.01), diastolic grade (r\u00a0=\u00a0\u22120.5, P\u00a0=\u00a00.01), E\u2032 velocity (r\u00a0=\u00a00.6, P\u00a0=\u00a00.0001), peak A velocity (r\u00a0=\u00a0\u22120.5, P\u00a0=\u00a00.004), and LAVI<\/jats:styled-content> (r\u00a0=\u00a0\u22120.6, P\u00a0=\u00a00.002).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Left atrial dysfunction is evident in stage 3 CKD<\/jats:styled-content> with associated LA<\/jats:styled-content> enlargement. This study demonstrates that LA GS<\/jats:styled-content> and SR<\/jats:styled-content> were reduced in the CKD<\/jats:styled-content> group despite similar LAVI<\/jats:styled-content> in the CKD<\/jats:styled-content> with HT<\/jats:styled-content> and HT<\/jats:styled-content> group. Hence LA GS<\/jats:styled-content> and SR<\/jats:styled-content> may be a more sensitive noninvasive tool to detect cardiovascular involvement in CKD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.12503","type":"journal-article","created":{"date-parts":[[2014,1,22]],"date-time":"2014-01-22T07:34:17Z","timestamp":1390376057000},"page":"956-964","source":"Crossref","is-referenced-by-count":25,"title":["Chronic Kidney Disease is Independently Associated with Alterations in Left Atrial Function"],"prefix":"10.1111","volume":"31","author":[{"given":"Krishna K.","family":"Kadappu","sequence":"first","affiliation":[{"name":"South Western Sydney Clinical School The University of New South Wales Sydney Australia"},{"name":"Cardiology Department Liverpool Hospital Liverpool Australia"},{"name":"Cardiology Department Campbelltown Hospital University of West Sydney Campbelltown Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ario S.","family":"Kuncoro","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine University of Indonesia National Cardiovascular Centre Harapan Kita Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leia","family":"Hee","sequence":"additional","affiliation":[{"name":"Cardiology Department Liverpool Hospital Liverpool Australia"},{"name":"University of Sydney Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anathakrishnapuram","family":"Aravindan","sequence":"additional","affiliation":[{"name":"Cardiology Department Campbelltown Hospital University of West Sydney Campbelltown Australia"},{"name":"Renal Department Liverpool Hospital Liverpool Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen T.","family":"Spicer","sequence":"additional","affiliation":[{"name":"South Western Sydney Clinical School The University of New South Wales Sydney Australia"},{"name":"Renal Department Liverpool Hospital Liverpool Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govindarajan","family":"Suryanarayanan","sequence":"additional","affiliation":[{"name":"Cardiology Department Campbelltown Hospital University of West Sydney Campbelltown Australia"},{"name":"Renal Department Liverpool Hospital Liverpool Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xuan","sequence":"additional","affiliation":[{"name":"South Western Sydney Clinical School The University of New South Wales Sydney Australia"},{"name":"Ingham Institute of Applied Medical Research Liverpoool Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Boyd","sequence":"additional","affiliation":[{"name":"South Western Sydney Clinical School The University of New South Wales Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John K.","family":"French","sequence":"additional","affiliation":[{"name":"South Western Sydney Clinical School The University of New South Wales Sydney Australia"},{"name":"Cardiology Department Liverpool Hospital Liverpool Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza","family":"Thomas","sequence":"additional","affiliation":[{"name":"South Western Sydney Clinical School The University of New South Wales Sydney Australia"},{"name":"Cardiology Department Liverpool Hospital Liverpool Australia"},{"name":"University of Sydney Sydney 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