Investigation Of Left Ventricular Function In Maintenance Hemodialysis Patients By Using 2DSTI And Correlative Factors Of Pulmonary Hypertension

Objective To evaluate left ventricular torsion and global systolic function in maintenance hemodialysis patients by using two-dimentional speckle tracking imaging(2DSTI),and to investigate the correlative factors of pulmonary hypertension(PH).Methods The study population consisted of 68 maintenance hemodialysis patients who were created arteriovenous fistula(AVF) in Blood Purification Centre of Bozhou people’s hospital.and 30 healthy volunteers.The patients were divided into no-PH and mild,moderate,severe PH groups.Doppler echocardiography examination.Systolic pulmonary arterial pressure(s PAP) were recorded by tricuspid regurgitation, Vascular access flow were performed(Qa), and Left ventricular ejection fraction(LVEF) were record by modified Simpson method in all study objects. Left ventricular short axis basal segment torsion Angle peak(Prot-B), apex section torsion Angle peak(Prot-A), the overall torsion Angle peak(Ptw-All) and Left ventricular global longitudinal strain(GLS) and left ventricular global circumferential strain(GCS) were measured by 2DSTI.The differences between two groups were compared,and the diagnose value were analyzed.The correlative factors of PH with Left ventricular systolic function,Dialytic age,Patient age,Sex were investigated.Results 1 、 45 patients(45/68,66.2%) had PH. the mean value for duration on hemodialysis(in months) was 22.1±13.5 and those without PH was 13.8±11.9. More the dialytic age, more severe the PH was. Correlation analysis showed that PH were positive correlated with dialytic age(r=0.324,P<0.001).(Pulmonary arterial pressure profile with dialysis time distribution, Figure 3).2、Compared with control group, SBP and DBP increased in all dialysis patients.the difference was statistically significant(P <0.05), and PH group SBP high no PH group, the difference was statistically significant(P< 0.05).3、Moderately、severe PH group compared with other groups have lower LVEF,the difference was statistically significant(P < 0.05), while mild PH and no PH group was no statistically significant difference compared with control groups.4、Compared with control groups, torsion function and GLS、GCS decreased in patients. the difference was statistically significant(P < 0.05).With the severity of PH,GLS and GCS decreased progressively. Correlation analysis showed that GLC,GCS were negatively correlated with pulmonary arterial pressure(r=-0.45,-0.34,P<0.01)。Conclusion 1.Left ventricular torsion and global systolic function quantitatively can be evaluated by 2DSTI, and 2DSTI was more sensitive than conventional echocardiographic.2.PH was positively related with dialysis time. the longer dialysis,pulmonary hypertension was the more serious.3、The risk of pulmonary hypertension in women was higher than that in men, but no significant correlation was found.4 、Pulmonary arterial pressure were negatively correlated with myocardia systolic function. The more severe pulmonary arterial pressure, the more obvious the left ventricular function decreased.