To study left atrial volume and left atrial volume index as echocardiographic markers of cardiovascular involvement in patients with chronic kidney disease
Dr. Shiv Charan, Dr. Rakesh Aggrawal, Dr. Harsh Bala, Dr. Surbhi Mahajan, Dr. Bhupinder Singh
Background: Chronic Kidney Disease is a global public health problem and a major risk factor for cardiovascular disease. Hence, it becomes a necessity to identify the predictors of cardiovascular involvement in patients with Chronic Kidney Disease. The present study was done to assess the presence of Left atrial volume (LAV) and Left atrial volume index (LAVi) in patients of CKD stages as markers of cardiovascular involvement. Materials and Methods: This cross sectional study included sixty patients (n=60) from the randomly selected cases admitted in emergency and indoor medical wards of Guru Nanak Dev Hospital, Amritsar. The sample was divided into three groups of twenty each on the basis of GFR. Group 1 consisted of CKD stage 3 patients, Group 2 consisted of CKD Stage 4 patients and Group 3 consisted of CKD Stage 5 patients. Detailed history, clinical examination and relevant investigations including testing of various biochemical parameters, Electrocardiogram, X-ray Chest PA View and Two Dimensional Transthoracic Echocardiography were done in every patient. Values of Left Atrial Diameter (LAD), Left Atrial Volume (LAV) and Left Atrial volume index (LAVi) were assessed in each of the three groups. Diastolic Dysfunctionand values of Ejection Fraction were also assessed in each of the three groups and correlated with Left Atrial Volume Index (LAVi). The data was collected systematically and analysed according to standard statistical methods. Results: Increased value of LAVi (>34 mL/m2) was 15% in Group 1, 40% in Group 2, and 65% in Group 3. Increased left atrial volume was significantly related to decreased ejection fraction in CKD stage 4 and 5 (p<0.05). Conclusion: Earlier detection of increased left atrial volume index in CKD patients is imperative as it can further help in deciding the prognosis of the patients.