| Objective:This study’s objective was to evaluate the incidence of impaired left ventricular(LV)global longitudinal strain(GLS)and preliminarily investigate the related factors in end-stage renal disease(ESRD)patients with preserved LV ejection fraction(LVEF)associated with the impaired GLS,in order to assist in the clinical optimization of treatment plan.Methods:A total of 100 inpatients and outpatients with ESRD,including 68 males and 32 females,with an average age of(52±15)years,were recruited from September 2019 to May 2020.The general clinical data of the patients,the biochemical indicators of the first admission,were collected.The dimension of LV at end-diastole(LVEDd)and end-systole(LVESd),septal wall thickness(IVSd),and posterior wall thickness(PWTd)were measured by from the parasternal long-axis view.The LV mass was determined using the Devereux formula.Left ventricular mass index(LVMI)was the ratio of LVM to body surface area.The LVEF was determined by utilizing biplane Simpson’s method.3 standard apical views(4-chamber,2-chamber,and 3-chamber)were acquired and storied by grayscale images and the strain Bull’s eye plot of 17 segments of left ventricular wall were obtained by automated function imaging(AFI).The GLS was calculated as the average of peak longitudinal strain from 17 myocardial segments obtained utilizing the 3 standard apical views.According to a predefined cutoff,a GLS absolute value of less than 18% was considered subclinical LV systolic dysfunction.Then,all patients were divided into GLS ≥ 18% group and GLS < 18% group,and were statistically analyzed.Results:1.Of the 100 patients with ESRD enrolled in the study,58(58/100,58%)had left ventricular GLS < 18%,42(42/100,42%)had LV GLS ≥ 18%.2.Compared to LV GLS ≥ 18% participants,LVEF was decreased significantly,LVEDd,LVESd,LVMI were increased significantly,IVSd and PWTd were significantly thickened in patients with a GLS < 18%,the difference was statistically significant(P < 0.05).3.The prevalence of left ventricular hypertrophy in participants with GLS < 18%was relatively high(68%,68/100).In 68 ESRD patients with left ventricular hypertrophy,there were 47 patients in the GLS < 18% group and 21 patients in the GLS ≥ 18% group.Compared to ESRD participants with non-left ventricular hypertrophy,GLS was significantly decreased in those with left ventricular hypertrophy(19.0±2.4% vs.16.4±3.2%,P < 0.001).4.Linear correlation analysis showed that GLS and LVMI(r =-0.576,P <0.001),LVEDd(r =-0.328,P < 0.01),LVESd(r =-0.467,P < 0.01)were negative correlation;GLS was positively correlated with LVEF(r = 0.468,P < 0.01).5.Multivariate binary Logistic regression analysis exhibited that LV mass index was independently associated with impaired GLS < 18%(OR = 1.028,95% CI(1.004-1.052),P = 0.020).Conclusion:1.The incidence of impaired LV GLS in ESRD patients with preserved LV ejection fraction was relatively high.2.Left ventricular mass index is an independent related factor for left ventricular longitudinal systolic dysfunction.3.Echocardiography can detect the subclinical longitudinal systolic dysfunction of the left ventricle in early stage,which can provide an important basis for the clinical optimization of treatment plan. |
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