Assessement Of Left Atrial Function In Patients With Chronic Kidney Disease:Strain Rate Imaging Study

ObjectivesThe aim of this study was to assess the left atrial function by Strain Rate Imaging(SRI)technology in patients with chronic kidney disease(CKD)and the changes of left ventricle at an early stage of CKD.Materials and Methods82 patients with chronic kidney disease(CKD)and 44 normal subjects from the NO.88 PLA hospital were investigated in this study.The patients with CKD were divided into two groups according to the CKD staging definition of United States:CKD stage 1-3 and CKD stage 5.The healthy groups were confirmed be healthy through physical examination.Besides,all the people should be have no history heart diseases and the LVEF>50%,the people whose LVEF<50% were excluded from our research.Device: ultrasonic diagnostic apparatus of GE from America.Methods: make sure that the ECG was connected well.By echocardiography,in 2D mode,the maximum front and back diameter of the left atrium(LAD)were measured.Then LVEF was acquired by M mode ultrasound.Then the velocity of E wave(E),A wave(A)were measured by pulsed wave Dopplor,and the E/A ratio was calculated.The peak early diastolic velocity of the septal mitral annulus(E′),the peak late diastolic velocity of the septal mitral annulus(A′)were masured by Tissue Doppler,and the E′/A′ ratio was calculated.The strain rate curve including systolic strain rate,early and late diastolic strain rate(SRs,SRe,SRa)was obtained from the middle of left atrium intertribal septum,lateral wall,lower wall,front wall and back wall in the apical four chamber view,apical two chamber view,apical three chamber view.Finally,the left atrium systolic function of patients with CKD and normal individuals were analyzed.Results1.In the early stage of CKD(CKD1-3)and the patients with renal failure,the whole strain rate of left atrium(mSRs and mSRe)are lower than the control group,and the strain rate(SRs and SRe)are lower than the control group.However,the SRa and mSRa are in normal limits.2.The dimeter of the left atrium is normal in the early stages of CKD,but become enlarged in patients with renal failure.3.The diastolic function is normal in the early stages of CKD and is abnormal in patients with renal failure The left ventricular systolic function of the patients with renal failure have also been injured.ConclusionThe strain rate imaging technology can be used to evaluate the structure and function of the left atrium of the patients with CKD at an early time.