Application of Speckle-Tracking Echocardiography in Detecting Coronary Artery Disease in Patients with Maintenance Hemodialysis

Abstract

BACKGROUND: Satisfactory and noninvasive diagnostic tools for coronary artery disease (CAD) are not available in hemodialysis patients. We aimed to elucidate a reliable tool to diagnose CAD in these patients. METHODS: 102 hemodialysis patients received 2D speckle-tracking echocardiography with left ventricular (LV) strain analysis and blood tests for cardiac troponin T, high-sensitive C-reactive protein, interleukin (IL)-6, and IL-18. RESULTS: The levels of biomarkers did not differ between patients with and without CAD. The factors associated with CAD were decreased circumferential strain, decreased global longitudinal strain, and the number of LV segments with decreased longitudinal strain. Logistic regression analyses showed that the number of LV segments with decreased longitudinal strain, over 6 segments, was strongly associated with CAD in hemodialysis patients (OR 12.08, 95% CI 3.724-39.209). CONCLUSIONS: The noninvasive modality of speckle-tracking echocardiography with strain analysis is efficient and objective for identifying CAD in hemodialysis patients.