The Assessment Of Left And Right Ventriculars Function By Colour Tissue Doppler Imaging In Patients With End-Stage Renal Disease

Objective To explore the value of tissue doppler imaging(TDI) in the evaluation of left and right ventricular function in patients with end-stage renal disease (ESRD) .Methods 31 patients with ESRD and 31 healthy subjects were studied in the article.The patients with ESRD were measured connective parameters 30 minues after hemodialysis and before hemodialysis .Left atrium internal dimensions (LAD) in end diastole were measured by 2D echocardiography. Interventricular septum thickness (IVSd),Left ventricular posterior wall thickness (LVPWd),Left ventricular internal dimensions (LVIDd) in end diastole were measured by M-mode echocardiography. LV mass was calculated by the Devereux-modified American Society of Echocardiography cube formula and indexed for body surface area to obtain the LV mass index. Conventional left and right ventricular diastolic function parameters were acquired by pulsed Doppler.Including to the mitral and the tricuspid flow velocity, deceleration time of early diastolic mitral and tricuspid flow, and the E/A ratio was calculated. Left ventricular eject faction(EF) was assessed by improved Simpson formular.The mitral annular and the tricuspid annular peak stolic (S_m),early diastolic (E_m) and peak late (A_m)velocities, isovolumetric contraction time and isovolumetric relaxation time were determined by Color TDI in the apical views (4—and2-chamber, andlong-axis) ,and the Em/Am, the E/Em and Tei index were calculated. Then the function parameters of the ESRD group were compared with the healthy group, and the corrections between the parameters were analyzed.Results The ESRD patients had lower mitrial and tricuspid E/A ratio, had significantly longer isovolumetric relaxation time and deceleration time than the healthy subjects. Mean S_m,mean E_m,mean E_m/A_m were significantly reduced in Hemodialysis groups with ESRD compared with health contral groups,and before HD were higher than after HD. while LAD, LVMI, LVIDd, Tei index and E/mean E_m were significantly increased ,and before HD were higher than after HD, but Tei index after HD were higher than before HD. mean E_m correlated positively with mean E_m/A_m(r=0.854). the lateral of right ventricular E_m correlated positively with the lateral of right ventricular E_m/A_m(r=0.710), mitrial E/A ratio correlated positively with mean E_m/A_m(r=0.867), tricuspid E/A ratio correlated positively with the lateral of right ventricular E_m/A_m(r=0.236), EF correlated positively with S_m(r=0.549) and E/mean Em correlated positively with LAD(r=0.480). Conclusions1.Patients with ESRD had left and right ventriculars diastolic dysfunction,and so were systolic function, cardiac function would be reduced after hemodialysis.2.Systolic was impaired in patients with ESRD with normal ejection fraction.3.Tei indexs of left and right ventricular were high in the patient with ESRD,. Tei indexs were more sensitive than ejection fraction.in assessing cardiac function.4.TDI parameters correlate well with Conventional echocardio-graphy's.