Meta-analysis of the correlation between pulmonary hypertension and echocardiographic parameters in patients with chronic kidney disease

TL;DR

This study finds that specific echocardiographic parameters are correlated with pulmonary hypertension in patients with chronic kidney disease.

Contribution

The study provides a meta-analysis of echocardiographic parameters linked to CKD-related pulmonary hypertension.

Findings

LA showed the highest correlation with CKD-PH (0.70 < r < 0.89).

LVDD, RA, RV, LVMI, and LVDS showed moderate correlations with CKD-PH.

PA, IVS, LVPW, SV, FS, and LVEF showed low correlations with CKD-PH.

Abstract

To investigate the correlation between pulmonary hypertension (PH) and echocardiographic parameters in patients with chronic kidney disease (CKD).

PubMed, Embase, Web of Science, Cochrane, VIP, CNKI, and Wanfang databases were systematically searched for articles published from inception to 19 May 2023. Study quality was estimated using the Quality Assessment of Case-Control Studies tool. Forest plots were drawn using R language software. The “metacor” function in the “meta” package was utilized for meta-analysis of the r-values and their standard errors. Heterogeneity and sensitivity analyses were carried out, with the main outcomes as r-value, p-value, and I2 value.

Eleven studies were included, with 1,809 CKD patients. The correlations between 12 echocardiographic parameters and PH were analyzed. Except for FS and LVEF which were negatively correlated with CKD-PH, the other 10 parameters were positively correlated with CKD-PH. Among them, LA was highly correlated with CKD-PH (0.70 < r < 0.89); LVDD, RA, RV, LVMI, and LVDS were moderately correlated with CKD-PH (0.40 < r < 0.69); while PA, IVS, LVPW, SV, FS, and LVEF were lowly correlated with CKD-PH (0.20 < r < 0.39). The synthesized estimates were stable against heterogeneity.

CKD-PH patients may have large cardiac chambers, thickened septal tissue on both sides of the chambers, reduced pulmonary artery flow rates, and decreased left ventricular function.

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