Evaluation Of Left Ventricular Regional Systolic And Diastolic Function By Strain Rate Imaging In Uremic Patients With Normal Ejection Fraction

Objective:To evaluate the left ventricular regional longitudinal systolic and diastolic function by strain rate imaging(SRI) in uremic patients with normal ejection fraction(EF)Methods:(1) Subject 41 patients with uremia and 20 healthy controls were enrolled, and the contrast studies were performed by echocardiogram.(2) Instrument Standard echocardiography in this study was performed by a Philips IE33 with prode S5-1 with 1-5MHz array transducer. QLAB-SQ imaging analysis and processing software can be used to get the strain rate curves and analyze the movement of the segments quantitatively.(3) Methods Basic clinical data such as age, gender, body weight, body height, blood pressure and heart rate were collected. Then the following parameters were measured by conventional two-dimensional echocardiography:left, right atrium and ventricle end diastolic diameter, inter ventricular septal(IVS) thickness,left ventricular post wall(LVPW) thickness,ejection fraction(EF) were measured by Simpson's method, transmitral flow velocities(E,A)were also measured and E/A ratio were calculated.Standard apical 2,3 and 4-chamber views of left ventricle of Tissue Doppler images(TDI) were obtained and myocardial TDI datas were stored.Then the datas were analyzed offline by QLAB-SQ software. SRI curves in middle and basal segments of anterior,inferior,pre-septum,posterior,laterior,post septum walls were analyzed.Peak systolic strain rate(SRs),peak early diastolic strain rate(SRe) and peak late diastolic strain rate(SRa) values were measured on every curve,and SRe/SRa were calculated. All data were average of three cardiac cycles.(4) Statistical analysis All the analyses were performed using SSPS 13.0 and quantitative data were compared using t test.Results:(1) Compared with the control group about Basic clinical data and conventional two-dimensional echocardiography parameters:the age,the gender composition,the heart rate,the values of left ventricle end diastolic diameter,and the EF between the uremia group and the control group has no statistical variance(p＞0.05), the values of the thickness of left ventricular wall of the uremia group are more than those in the control group significantly(p＞0.05).(2) Compared with the control group about the strain rate:the numerical values of all segmented SRs,SRe and SRe/SRa of uremia group are less than those in the control group significantly(p＞0.05).Conclusions:There have been diffuse abnormalities of regional systolic and diastolic function of left ventricle in uremic patients with normal ejection fraction,and these abnormalities can be disclosed sensitively and quantitatively by SRI.