Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan;42(1):e70064.
doi: 10.1111/echo.70064.

Association Between Myocardial Work and Coronary Artery Calcium Score in Patients With Chronic Kidney Disease

Flemming Javier Olsen  1   2 , Nino Emanuel Landler  1   2 , Jacob Christensen  1   2 , Klaus Fuglsang Kofoed  3   4 , Bo Feldt-Rasmussen  4   5 , Ditte Hansen  4   6 , Christina Christoffersen  7   8 , Ellen Linnea Freese Ballegaard  4   5 , Ida Maria Hjelm Sørensen  5 , Sasha Saurbrey Bjergfelt  5   7 , Eline Seidelin  6 , Susanne Bro  5 , Tor Biering-Sørensen  1   2   3   9
Affiliations

Association Between Myocardial Work and Coronary Artery Calcium Score in Patients With Chronic Kidney Disease

Flemming Javier Olsen et al. Echocardiography. 2025 Jan.

Abstract

Background: Myocardial work is a novel measure of potential value for diagnosing coronary artery disease (CAD). It may therefore be useful in patients with chronic kidney disease (CKD), in whom the diagnostic work-up can be challenging.

Methods: This was a cross-sectional study of patients with CKD (G1-5, nondialysis-dependent). Cardiac computed tomography was performed to quantify coronary artery calcium score (CACS). Pressure-strain loop analysis was performed to obtain global and territorial work index (GWI and TWI, respectively). Logistic regression was applied to investigate the association between work measures and high CACS (>400).

Results: We included 455 patients (age: 57 years, 60% men, 8% with previous CAD, and eGFR of 43 mL/min/1.73 m2). High CACS across all coronary arteries was observed in 77 (17%), with 53 (12%) in the left anterior descending (LAD) artery, 28 (6%) in the right coronary artery (RCA), and 17 (4%) in the circumflex (Cx) artery. No difference in GWI was observed for overall high versus non-high CACS (1861 vs. 1937 mmHg%, p = 0.14). TWI was reduced in patients with high versus non-high CACS in the LAD (1772 vs. 1956 mmHg%, p = 0.003) and in the Cx (1556 vs. 1934 mmHg%, p = 0.001), but not in the RCA (p = 0.68). After multivariable regression, TWI remained significantly associated with high CACS in the LAD and Cx in patients with no history of CAD, but not in the RCA.

Conclusion: In patients with CKD, GWI was not associated with an overall high CACS. TWI was, however, associated with a high CACS in specific coronary arteries, although the findings were inconsistent.

Keywords: coronary artery disease; kidney disease; myocardial work; nephropathy; pressure‐strain.

PubMed Disclaimer

References

    1. G. Manjunath, H. Tighiouart, H. Ibrahim, et al., “Level of Kidney Function as a Risk Factor for Atherosclerotic Cardiovascular Outcomes in the Community,” Journal of the American College of Cardiology 41, no. 1 (2003): 47–55.
    1. A. S. Go, G. M. Chertow, D. Fan, C. E. McCulloch, and H. C. Yuan, “Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and Hospitalization,” New England Journal of Medicine 351, no. 13 (2004): 1296–1305.
    1. J. Knuuti, W. Wijns, A. Saraste, et al., “2019 ESC Guidelines for the Diagnosis and Management of Chronic Coronary Syndromes,” European Heart Journal 41, no. 3 (2020): 407–477.
    1. A. Schmidt, T. Stefenelli, E. Schuster, and G. Mayer, “Informational Contribution of Noninvasive Screening Tests for Coronary Artery Disease in Patients on Chronic Renal Replacement Therapy,” American Journal of Kidney Diseases 37, no. 1 (2001): 56–63.
    1. L. W. Wang, M. A. Fahim, A. Hayen, et al., “Cardiac Testing for Coronary Artery Disease in Potential Kidney Transplant Recipients,” Cochrane Database of Systematic Reviews (Online) 2011, no. 12 (2011): CD008691.

MeSH terms

Grants and funding