European Journal of Cardiovascular Medicine

This study was conducted to evaluate the prognostic significance of global longitudinal strain and e/e’ versus ejection fraction of the left ventricle by echocardiography in predicting morbidity and all-cause mortality in kidney disease patients. Methods: This was a hospital-based study conducted among 56 consecutive patients suffering from renal disease in the Department of Cardiology and Nephrology at DYP Hospital, over a period of 12 months, from September 2022 to August 2023, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: In patient death analysis for LVEF and in patient death analysis for GLS, the difference was statistically significant. All cases that died had an abnormal E/e ratio, which is greater than those that survived and is statistically significant. There were 28 patients with LVEF < 50%, and their mean LVEF was 35.14%, out of which 8 patients died during the study period. There was a 12% reduction in LVEF at the end of the one-year study; this reading was statistically significant. There were 28 patients with LVEF >50%, and their mean LVEF was 56.42%. During the study, 2 patients died and survived, and 26 patients had a mean LVEF of 52.05%. There was a 7% reduction in LVEF at the end of the study; as compared to LVEF <50%, there is minimal change in the reduction of LVEF; the findings are statistically significant. There were 45 patients with abnormal GLS whose mean GLS was -10.5%, out of which 10 patients died during the study; the follow-up mean GLS reading of the survived patient was -9.75%; it has deteriorated by 7%; this finding is statistically significant; and those who have normal GLS had a mean of -16.11% and a follow-up mean of 15.71%; there was a 7% deterrence of GLS in one year of study; the findings were statistically significant. Conclusion: Abnormal GLS is a good prognostic marker of morbidity and mortality in chronic kidney disease patients. The study indicates that global longitudinal strain is a superior guide to estimating LV function than LVEF for detecting myocardial dysfunction in CKD. Larger-scale CKD population studies are needed to verify if GLS offers patients an additional prognostic value when compared to LVEF.