Vector flow mapping analysis of left ventricular vortex performance in type 2 diabetic patients with early chronic kidney disease

• Published in: BMC cardiovascular disorders Vol. 23; no. 1; pp. 1 - 11
• Main Authors: Chen, Xiaoxue, Qiu, Fang, Wang, Wei, Qi, Zhengqin, Lyu, Damin, Xue, Kun, Sun, Lijuan, Song, Degang
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 01.09.2023; BioMed Central; BMC
• Subjects: Blood flow; Blood glucose; Cardiovascular disease; Care and treatment; Chronic kidney disease; Complications and side effects; Correlation analysis; Demographics; Diabetes; Diabetes mellitus; Diagnosis; Diastolic dysfunction; Early stages; Flow velocity; Glycemia; Health care; Heart; Hemodynamics; Hemoglobin; Hyperglycemia; Kidney diseases; Left ventricular vortex; Mapping; Medical research; Medicine, Experimental; Observations; Software; Type 2 diabetes; Vector flow mapping; Ventricle; Vortices; China
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-023-03474-7

Background Diabetes is the leading cause of chronic kidney disease (CKD) and contributes to an elevated incidence of diastolic dysfunction in the early stages of CKD. Intracardiac vortex is a novel hemodynamic index for perceiving cardiac status. Here, we visualized left ventricular (LV) vortex characteristics using vector flow mapping (VFM) in type 2 diabetic patients with early CKD. Methods This cross-sectional study included 67 controls and 89 type 2 diabetic patients with stages 2-3a CKD. All subjects underwent transthoracic echocardiographic examination. LV anterior vortex during early diastole (E-vortex), atrial contraction (A-vortex) and systole (S-vortex) were assessed using VFM in the apical long-axis view. Its relation to glycemia or LV filling echocardiographic parameters were further analyzed using correlation analysis. Results Type 2 diabetic patients with early CKD had a small area (439.94 [+ or -] 132.37 mm.sup.2 vs. 381.66 [+ or -] 136.85 mm.sup.2, P = 0.008) and weak circulation (0.0226 [+ or -] 0.0079 m.sup.2/s vs. 0.0195 [+ or -] 0.0070 m.sup.2/s, P = 0.013) of E-vortex, but a large area (281.52 [+ or -] 137.27 mm.sup.2 vs. 514.83 [+ or -] 160.33 mm.sup.2, P Ë 0.001) and intense circulation (0.0149 [+ or -] 0.0069 m.sup.2/s vs. 0.0250 [+ or -] 0.0067 m.sup.2/s, P < 0.001) of A-vortex compared to controls. CKD patients with poorly controlled hyperglycemia had stronger A-vortex (area: 479.06 [+ or -] 146.78 mm.sup.2 vs. 559.96 [+ or -] 159.27 mm.sup.2, P = 0.015; circulation: 0.0221 [+ or -] 0.0058 m.sup.2/s vs. 0.0275 [+ or -] 0.0064 m.sup.2/s, P < 0.001) and S-vortex (area: 524.21 [+ or -] 165.52 mm.sup.2 vs. 607.87 [+ or -] 185.33 mm.sup.2, P = 0.029; circulation: 0.0174 [+ or -] 0.0072 m.sup.2/s vs. 0.0213 [+ or -] 0.0074 m.sup.2/s, P = 0.015), and a longer relative duration of S-vortex (0.7436 [+ or -] 0.0772 vs. 0.7845 [+ or -] 0.0752, P = 0.013) than those who had well-controlled hyperglycemia. Glycemia, and E/A (a LV filling parameter) were respectively found to had close correlation to the features of A-vortex and S-vortex (all P < 0.05). Conclusions Abnormal LV vortices were detected in type 2 diabetic patients with early CKD using VFM, especially in those who neglected hyperglycemic control. LV vortex might be a promising parameter to slow or halt the hyperglycemia-induced diastolic dysfunction in early CKD. Keywords: Left ventricular vortex, Vector flow mapping, Chronic kidney disease, Diastolic dysfunction, Glycemia, Early stages