Ultrasound Evaluation Of Left Atrial Function In Patients With Uremia Before And After Hemodialysis By Strain Rate Imaging

Objective:1. To evaluate left atrial (LA) function in patients with uremia by strain rate imaging(SRI).2. To evaluate the changes of the left atrial function in patients with uremia before and after hemodialysis by strain rate imaging.Methods:1.31patients with uremia without overt heart disease and20normal subjects (control group) were studied by echocardiography;2.31patients with uremia without overt heart disease, receiving regular hemodialysis, were studied by echocardiography within one hour before and after hemodialysis. The biggest volume of LA were measured by Two-dimensional echocardiography; The peak E velocity(E), the peak A velocity(A)and E/A were measured by doppler echocardiography; The peak early diastolic annular and myocardial velocity(Ea), the peak late diastolic annular and myocardial velocity(Aa) and Ea/Aa were measured by doppler tissue imaging; Strain rate imaging (the peak systolic annular and myocardial velocity(SRs), the peak early diastolic annular and myocardial velocity (SRe), the peak late diastolic annular and myocardial velocity(SRa))were performed at left atrial of each walls(anterior, inferior, lateral and septal) and the average of the four sites was calculated.Results:1.Compared with normal subjects, E/A ratio, Ea and Ea/Aa ratio decreased and A and Aa increased in patients with uremia (p<0.01), while E was not significantly different (p>0.05). Left atrium SRI index:SRs, SRe were reduced in patients with uremia (p<0.01), but SRa increased (p<0.01).2. Compared with before hemodialysis, E, E/A ratio. Ea and Ea/Aa ratio decreased in patients with uremia after hemodalysis(p<0.01). while A and Aa were not significantly different(p>0.05). Left atrium SRI index: SRa increased after hemodialysis (p<0.01), but SRs, SRe were not significantly different (p>0.05).Conclusion:1. The strain rate imaging could be used to evaluate the left atrial function more accurately and directly in patients with uremia and could be used as another effective method to quantify left atrial function.2. Strain rate imaging is not affected by acute preload reduction, it can test the change of left atrial function objectively in the case of preload reduce and can evaluate the changes of the left atrial function in patients with uremia before and after hemodialysis more accurately compared with pulse doppler echocardiography and pulse doppler tissue imaging.