The Technique Of Strain And Strain Rate Imaging Assessing Contractile Function And Diastolic Function Of Left Ventricle And Right Ventricle About Uremia

Objective: Uremia could damage cardiac function. Conventional ultra- sound cardiography assesses global contractile function and diastolic function of heart by measuring left ventricular ejection fraction(LVEF), E peak and A peak of bloodstream spectra of mitral valve, however, it has limitations for assessing regional function. Strain and strain rate imaging describe deformation ability of cardiac muscle after getting strength and assess myocardial contractile function and diastolic function quantitatively. The aim of this study is to determine the value of strain and strain rate imaging in assessing contractile function and diastolic function of left ventricle and right ventricle about uremia.Methods: A group of 30 healthy adults(16 men and 14 women)were enrolled in normal controls, called group A. 34 patients with uremia were divided into two groups,18 patients in group B with non-hypertrophic left ventricle and 16 patients in group C with hypertrophic left ventricle. LVEF of group B and group C were more than 50%. The standard of hypertrophic left ventricle was: left ventricular mass index (LVMI)>115g/m2(male), LVMI>106g/m2(female), or interventricular septal thickness>12mm in end- diastole. The three groups were undertaken conventional echocardiography exam and the parameters of strain rate imaging were measured. The parameters measured were following up: 1. conventional ultrasound para- meters: systolic left atrium diameter(LAD), diastolic left ventricular diameter(LVDd), diastolic interventricular septal thickness (IVSTd), diasto- lic posterior left ventricular wall thickness (PWTd), left ventricular ejection fraction (LVEF), right ventricular diameter(RVD), E peak and A peak of bloodstream spectra of mitral valve and E/A. 2.The parameters of strain and strain rate for each segments of myocardium: the maximal strain in systolic(ε), systolic peak strain rate(SRs), early diastolic strain rate(SRe), later diastolic strain rate (SRa) and SRe/ SRa.Results:1.Conventional ultrasound parameters There were statistical difference in LA among the three groups, group A < group B group C, and there was no statistical difference.3.SRs In each segments of left ventricular wall of group B and group C they were smaller than those of group A(p<0.05), group B < group C, and there was no statistical difference. In basal segment and middle segment of RV, they were smaller in group B and in group C than those in group A(p<0.05). In basal segment group B < group C, in middle segment group B > group C, and there were no statistical difference.4.SRe In each segments of left ventricular wall in group B and group C they were smaller than those of group A(p<0.05), except in basal segment of IW, in middle segment of lateral wall(LW) and in middle segment of anterior wall(AW)(group B < group C), in the other segments they were higher in group B than those in group C, and there were no statistical difference. In basal segment and middle segment of RV, they were smaller in group B and in group C than those in group A(p<0.05). In basal segment group B < group C, in middle segment group B > group C, and there were no statistical difference.5.SRa They were smaller in partial segments of group B than that of group A in left ventricular wall(p>0.05), and in partial segments of group B they were higher than that of group A(in basal segment and middle segment of IW p<0.05, in other segments p>0.05). In subtotal segments of group C they were smaller than those of group A. In all the segments of group B they were higher than that of group C(p>0.05). In basal segment and middle segment of RV, group A < group B < group C(p<0.05 between group A and group C).6.SRe/ SRa In each segments of left ventricular wall in group B and group C they were smaller than those of group A(p<0.05). In basal segment and middle segment of RV, they were smaller in group B and group C than those in group A(p<0.05), group B > group C, and there was no statistical difference.7. Colour M-mode strain and strain rate The colour of strain and strain rate about left ventricular wall and right ventricular wall in group B and group C was lighter than that in group A, especially for group C, andεdelayed in partial segments of part C.Results: Strain and strain rate imaging could assess contractile function and diastolic function of left ventricular and right ventricular myocardium about uremia sensitively and quantitatively.