The Evaluation Of Left Ventricular Twisting Motion Changes In Uremia Patients After Different Hemodialysis Time By STI

Object:The evaluation of left ventricular rotation and twisting motionchanges in uremia patients after different dialysis time by using2D-STItechnology, and to explore its relationship with the dialysis time,providing a simple and accurate method of cardiac function change inuremia patients after different dialysis time for clinic evaluation.Methods：Selecting90cases of maintenance hemodialysis uremia patients asstudy group，according to different dialysis time period will be dividedinto three groups: A group（<one year）,B group（one~three year）,Cgroup（> three year）；At the same time selecting30cases of healthyvolunteers as control group (N group).Check the left lateral position,quiet breathing and simultaneously recorded three lead ECG.Using S5-1ultrasound probe on standard left ventricular long axis measurement:interventricular septal end-diastolic thickness （IVSTd） and leftventricular posterior wall end-diastolic thicknes（sLVPWTd),using doubleplane Simpson method to measure left ventricular end-diastolic volume（LVEDV） and left ventricular end-systolic volume（LVESV）,obtaining left ventricular stroke volume （LVSV）,calculating left ventricular ejection volume（LVEF）.When the subjectsare inspiratory breathless and stable heart rate，sampling for three consecutive cardiac cycle sternum left ventricular short axis basal leveland apex level two-dimensional gray-scale dynamic images. Thetwo-dimensional dynamic images import QLAB6.0WorkstationandOffline analysis. After running the software to get the rotation angle-time curves of left ventricular short axis basal level and apexlevel.Measuring peak of left Ventricular basal rotation,peak of leftVentricular apical rotation， and calculating peak of left VentricularGlobal Twist. Average value of measuring data are three times.Results:1. The conventional parameters LVEDV,IVSTd,LVPWTd:N,A,B,C four groups gradually increased, comparative differencesbetween the groups were statistically significan（tP<0.05）；LVEF,LVSV：N,A,B,C four groups gradually decreased, comparative differencesbetween the groups were statistically significant（P<0.05）.2.（1） Four groups of the subjects basal level rotation angle curveare basically identical，systolic clockwise and peaking at the end-systolic，it is negative.Left ventricular short axis basal level of each segment roomwall rotation angle peak：A group lower than N group，only the reductionof BIL And BI had statistically significant differences（P<0.05），thereduction of rest segment room wall had no statistically significantdifference; B and C groups were significantly lower than N group, thedifferences were statistically significant（P<0.05）；B and C groups werelower than A group, the differences were statistically significant（P<0.05）；C,B to reduce no statistically significant difference betweenthe two groups. （2）Four groups of the subjects apex level rotation angle curve arebasically identical， systolic counterclockwise and peaking at theend-systolic，it is positive. Left ventricular short axis apex level of eachsegment room wall rotation angle peak：A,B,C three groups graduallylower than N group， the differences were statistically significant（P<0.05）；B and C groups were lower than A group, the differenceswere statistically significant（P<0.05）；C, B to reduce no statisticallysignificant difference between the two groups.(3) Peak of basal level global rotation：N,A,B,C four groups showeda trend of gradual decline，B, C two groups lower than N and A groups，the differences were statistically significan（tP<0.05）；A group lower thanN group,C group lower than B group, the differences were notstatistically significant；Peak of apex level global rotation：N, A, B, Cfour groups showed a trend of gradual decline， A,B,C three groupsgradually lower than N group， the differences were statisticallysignificant（P<0.05）；B and C groups were lower than A group, thedifferences were statistically significant（P<0.05）；C,B to reduce nostatistically significant difference between the two groups； Leftventricular global twist：N, A, B, C four groups showed a trend of gradualdecline，A,B,C three groups gradually lower than N group，the differenceswere statistically significant（P<0.05）；B and C groups were lower thanA group, the differences were statistically significant（P<0.05）；C,B to reduce no statistically significant difference between the two groups.（4）Peak of left ventricular global twist and LVEF and peak of apexlevel global rotation were highly correlated（r=0.828，p<0.05； r=0.955，p<0.05）.Conclusions:1. This study confirms that using2D-STI technology to measure thechanges of left ventricular each segment room wall rotation angle andglobal twisting angle in uremia patients after different dialysis time mayassess the cardiac function change of uremia patients after hemodialysis.2. Myocardial rotation angle of the uremia patients is lower than thegeneral population，so Left ventricular twisting function and systolicfunction also decline.3. With the extension of dialysis time， uremia patients leftventricular short axis each level,each segment room wall rotation angleand global twisting angle gradually reduce，and peak of left ventricularglobal twist and LVEF were highly correlated.