Coronary microcirculation and left ventricular diastolic function but not myocardial deformation indices are impaired early in patients with chronic kidney disease

Aim: . To investigate abnormalities in myocardial strain and classic echocardiographic indices and coronary flow reserve (CFR), in younger vs older CKD patients. Methods: . Sixty consecutive CKD patients (<60 years old n=30, ≥60 years old n=30) and 30 healthy controls (age- and gender-matched with younger CKD patients) were recruited. An echocardiographic assessment including myocardial strain indices was performed at baseline and following dipyridamole administration in all participants. Results: . Younger CKD patients had higher E/e’, left ventricular mass index and relative wall thickness and lower E’ (p<0.005 for all) compared to healthy controls. Older CKD patients had lower E/A and E’ (p<0.05 for both) compared to younger CKD patients; these differences did not remain significant after adjustment for age. CFR was higher in healthy controls compared to younger and older CKD patients (p<0.05 for both) without a significant difference between CKD groups. Dipyridamole-induced changes did not differ significantly among the 3 groups. Conclusions: . Compared to healthy controls, impaired coronary microcirculation and left ventricular diastolic function, but not myocardial strain abnormalities, are found in young CKD patients and deteriorate with aging.