Evaluation Of Left Ventricular Systolic Function And Synchronicity In Patients With Maintenance Hemodialysis By Speckle Tracking Imaging

ObjectiveTo explore the value of two-dimensional speckle tracking imaging(2D-STI)in evaluating the systolic function and synchronicity of left ventricle(LV)in maintenance hemodialysis(MHD)patients(LVEF>50%)by evaluating the difference and correlation of left ventricular geometry,systolic strain,twist and synchronicity parameters.MethodsForty-three maintenance hemodialysis(MHD)patients with preserved left ventricular ejection fraction(LVEF>50%)selected from People’s Hospital of Zhengzhou University were enrolled.Echocardiography were carried out in 12-24hours after hemodialysis.Forty-eight normal subjects were selected as the control group at the same time.Routine echocardiographic parameters and two-dimensional dynamic images of all subjects were acquired.EchoPAC was used to analyze longitudinal strain(LS),circumferential strain(CS),radial strain(RS),twist and peak strain dispersion(PSD).The difference and correlation of these parameters between the two groups were analysed.Results1.Global layer-specific strain parameters:The decline of GLSendo,GLSmid,GLSepi,GLS,GCSendo,GCSmid,GCSepi,GCS had statistically significant(P<0.01)in the in MHD patients.2.Segmental layer-specific strain parameters:The decline of bLSendo,bLsmid,bLSepi,mLSendo,mLSmid,mLSepi,aLSendo,aLSmid,aLSepi,bLS,mLS,aLS had statistically significant(P<0.01)in the in MHD patients.The decline of mCSendo,mCSmid,mCSepi,aCSendo,aCSmid,aCSepi,mCS,aCS had statistically significant(P<0.05)in the in MHD patients.There were no statistic difference between bCSendo,bCSmid,bCSepi,bCS(P>0.05).3.Between MHD group and the control group,the decline of GRS,bRS,mRS had statistically significant(P<0.01)in the in MHD patients.There was no significant difference between aRS(P>0.05).4.Compared with control group,the decline of RoB,Ta,T had statistically significant(P<0.05)in the in MHD patients.There was no statistic difference between RoA,Twist,Tb(P>0.05).No correlation were found between RoB,RoA,Twist,Tb,Ta,T and LVEF.5.The left ventricular synchronicity parameter peak strain dispersion(PSD)was significantly larger than control group(P<0.001).The internal consistency of PSD was good(ICC=0.815).Correlation analysis showed that PSD has positive correlated with left ventricular geometry parameters IVSd(r=0.466),LVPWd(r=0.498),LVMI(r=0.461),LVDd(r=0.472),LVESV(r=0.414),LVEDV(r=0.498).In addition,PSD has positive correlated with GLS in MHD group(r_s=0.478).Conclusion1.The left ventricular systolic function and synchronicity of MHD patients are impaired.Besides,there is correlation between systolic function and synchronicity.2.There is a decrease in global and layer longitudinal strain in MHD patients with preserved left ventricular ejection fraction.The normal LVEF of MHD patients may owe to the preservation of circumferential strain of basal segment,radial strain and the compensatory enhancement of twist.3.As a new parameter of 2D-STI,PSD is easy to acquire and has good repeatability,which made it a certain value of promotion.4.2D-STI can evaluae myocardial mechanical changes accurately and comprehensively and hasv a certain clinical application value.