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dc.contributor.authorKrishnasamy, R
dc.contributor.authorIsbel, NM
dc.contributor.authorHawley, CM
dc.contributor.authorPascoe, EM
dc.contributor.authorBurrage, M
dc.contributor.authorLeano, R
dc.contributor.authorHaluska, BA
dc.contributor.authorMarwick, TH
dc.contributor.authorStanton, T
dc.date.accessioned2020-02-20T23:32:06Z
dc.date.available2020-02-20T23:32:06Z
dc.date.issued2015
dc.identifier.issn1932-6203
dc.identifier.doi10.1371/journal.pone.0127044
dc.identifier.urihttp://hdl.handle.net/10072/391759
dc.description.abstractBackground: Echocardiographic global longitudinal strain (GLS) is increasingly recognised as a more effective technique than conventional ejection fraction (EF) in detecting subtle changes in left ventricular (LV) function. This study investigated the prognostic value of GLS over EF in patients with advanced Chronic Kidney Disease (CKD). Methods: The study included 183 patients (57% male, 63% on dialysis) with CKD stage 4, 5 and 5Dialysis (D). 112 (61%) of patients died in a follow up of 7.8 ± 4.4 years and 41% of deaths were due to cardiovascular (CV) disease. GLS was calculated using 2-dimensional speckle tracking and EF was measured using Simpson’s biplane method. Cox proportional hazard models were used to assess the association of measures of LV function and all- cause and CV mortality. Results: The mean GLS at baseline was -13.6 ± 4.3% and EF was 45 ± 11%. GLS was a significant predictor of all-cause [Hazard Ratio (HR) 1.09 95%; Confidence Interval (CI) 1.02–1.16; p = 0.01] and CV mortality (HR 1.16 95%; CI 1.04–1.30; p = 0.008) following adjustment for relevant clinical variables including LV mass index (LVMI) and EF. GLS also had greater predictive power for both all- cause and CV mortality compared to EF. Impaired GLS (>-16%) was associated with a 5.6-fold increased unadjusted risk of CV mortality in patients with preserved EF. Conclusions: In this cohort of patients with advanced CKD, GLS is a more sensitive predictor of overall and CV mortality compared to EF. Studies of larger populations in CKD are required to confirm that GLS provides additive prognostic value in patients with preserved EF.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherPublic Library of Science (PLoS)
dc.relation.ispartofissue5
dc.relation.ispartofjournalPLoS One
dc.relation.ispartofvolume10
dc.subject.fieldofresearchMedical and Health Sciences
dc.subject.fieldofresearchcode11
dc.titleLeft ventricular global longitudinal strain (GLS) is a superior predictor of all-cause and cardiovascular mortality when compared to ejection fraction in advanced Chronic Kidney Disease
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationKrishnasamy, R; Isbel, NM; Hawley, CM; Pascoe, EM; Burrage, M; Leano, R; Haluska, BA; Marwick, TH; Stanton, T, Left ventricular global longitudinal strain (GLS) is a superior predictor of all-cause and cardiovascular mortality when compared to ejection fraction in advanced Chronic Kidney Disease, PLoS One, 2015, 10 (5)
dcterms.dateAccepted2015-04-11
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.date.updated2020-02-20T23:29:34Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2015 Krishnasamy et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
gro.hasfulltextFull Text
gro.griffith.authorStanton, Tony


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