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Peer-reviewedCC BYMajalah Kardiologi Indonesia

Diastolic Function Parameters in Different Stages of Children with Chronic Kidney Disease: A Subclinical Speckle Tracking Echocardiography Study

  • Alles Firmansyah1
  • Didik Hariyanto2
  • Nani Nani3
  • Fitrisia Amelin4
4 affiliations
  1. 1Resident of the Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  2. 2Department of Cardiology and Vascular Medicine/Department of Pediatrics, M. Djamil Hospital, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  3. 3Department of Cardiology and Vascular Medicine, M. Djamil Hospital, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  4. 4Department of Pediatrics, M. Djamil Hospital, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
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Abstract

Background: Chronic Kidney Disease (CKD) in children was associated with an increased risk of long-term cardiovascular morbidity and mortality. Diastolic dysfunction, represented by an early cardiac manifestation of CKD, was often subclinical and might not be detected by conventional echocardiography. Speckle Tracking Echocardiography (STE), which assesses left atrial function, provided a potentially sensitive evaluation of early diastolic functional changes. This study aimed to compare stages of CKD in children with diastolic function parameters assessed by STE.

Methods: An analytic cross-sectional study conducted at RSUP M. Djamil Padang from September to December 2025, involving 44 children with CKD who were divided equally into two groups: Group I, early-stage CKD (stages 1–3) children, and Group II, advanced-stage CKD (stages 4–5) children. STE was performed to assess Left Atrial Reservoir Strain (LASr), Conduit Strain (LAScd), and Contractility Strain (LASct). Combination with echocardiography, conventional and STE by evaluating Left Atrial Stiffness Index (LASI) from E/e’ / LASr, and Left Atrial Filling Index (LAFI) from E transmitral velocity / LASr was performed in both groups. Statistical analyses included the Shapiro–Wilk normality test, followed by an independent t-test or Mann–Whitney test.

Results: In this study, no significant differences were found in age, sex, comorbidities, therapy, Left Ventricular Ejection Fraction (LVEF), and Left Atrium dimension between the two groups. The left atrial speckle tracking parameters in Groups I and II were as follows: LASr 44.89±2.22% vs 30.54±6.25% (p=0.000); LAScd ?33.50±3.66% vs. ?21.65±7.57% (p=0.000); LASct ?11.35% (?5.4 to ?17.8%) vs ?7.70% (?2.1 to ?21.0%) (p=0.018); LASI 0.15 (0.12–0.26) vs 0.32 (0.18–0.82) (p=0.000); and LAFI 1.99 (1.38–3.04) vs. 2.93 (2.19–6.65) (p=0.000).

Conclusions: Children with advanced-stage CKD demonstrated significantly reduced LASr, LAScd, and LASct and increased LASI and LAFI compared with those with early-stage CKD, indicating impaired diastolic function detected by left atrial STE.

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Cite

BibTeXRIS
BibTeX
@article{firmansyah2026diastolic,
  title = {{Diastolic Function Parameters in Different Stages of Children with Chronic Kidney Disease: A Subclinical Speckle Tracking Echocardiography Study}},
  author = {Alles Firmansyah and Didik Hariyanto and Nani Nani and Fitrisia Amelin},
  journal = {Majalah Kardiologi Indonesia},
  year = {2026},
  month = oct,
  doi = {10.30701/ijc.2117},
  url = {https://doi.org/10.30701/ijc.2117},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Diastolic Function Parameters in Different Stages of Children with Chronic Kidney Disease: A Subclinical Speckle Tracking Echocardiography Study
AU  - Alles Firmansyah
AU  - Didik Hariyanto
AU  - Nani Nani
AU  - Fitrisia Amelin
PY  - 2026
DA  - 2026/10/25
JO  - Majalah Kardiologi Indonesia
DO  - 10.30701/ijc.2117
UR  - https://doi.org/10.30701/ijc.2117
AB  - Background: Chronic Kidney Disease (CKD) in children was associated with an increased risk of long-term cardiovascular morbidity and mortality. Diastolic dysfunction, represented by an early cardiac manifestation of CKD, was often subclinical and might not be detected by conventional echocardiography. Speckle Tracking Echocardiography (STE), which assesses left atrial function, provided a potentially sensitive evaluation of early diastolic functional changes. This study aimed to compare stages of CKD in children with diastolic function parameters assessed by STE.  Methods: An analytic cross-sectional study conducted at RSUP M. Djamil Padang from September to December 2025, involving 44 children with CKD who were divided equally into two groups: Group I, early-stage CKD (stages 1–3) children, and Group II, advanced-stage CKD (stages 4–5) children. STE was performed to assess Left Atrial Reservoir Strain (LASr), Conduit Strain (LAScd), and Contractility Strain (LASct). Combination with echocardiography, conventional and STE by evaluating Left Atrial Stiffness Index (LASI) from E/e’ / LASr, and Left Atrial Filling Index (LAFI) from E transmitral velocity / LASr was performed in both groups. Statistical analyses included the Shapiro–Wilk normality test, followed by an independent t-test or Mann–Whitney test.  Results: In this study, no significant differences were found in age, sex, comorbidities, therapy, Left Ventricular Ejection Fraction (LVEF), and Left Atrium dimension between the two groups. The left atrial speckle tracking parameters in Groups I and II were as follows: LASr 44.89±2.22% vs 30.54±6.25% (p=0.000); LAScd ?33.50±3.66% vs. ?21.65±7.57% (p=0.000); LASct ?11.35% (?5.4 to ?17.8%) vs ?7.70% (?2.1 to ?21.0%) (p=0.018); LASI 0.15 (0.12–0.26) vs 0.32 (0.18–0.82) (p=0.000); and LAFI 1.99 (1.38–3.04) vs. 2.93 (2.19–6.65) (p=0.000).  Conclusions: Children with advanced-stage CKD demonstrated significantly reduced LASr, LAScd, and LASct and increased LASI and LAFI compared with those with early-stage CKD, indicating impaired diastolic function detected by left atrial STE.
SN  - 0126-3773
SN  - 2620-4762
ER  -