Preliminary Study Of Regional And Global Left Ventricular Systolic Function In Patients With Uremia Using XStrain^TM Echocardiography

ObjectiveThe study aims to assess the application and value of XStrainTM to build full volume image of left ventricular (LV) for measuring LV regional and global systolic function in uremic patients.Materials And MethodsA total of16normal controls (group A) and28uremic patients (group B:normal LV wall,12; group C:LV wall hypertrophy,16) subjects were investigated. Each patient had undergone conventional2D echocardiographic examination by using an Esaote Mylab Class ultrasound system with PA240section probe. The measurements of left ventricular parameters were achieved. Then, The dynamic images of apical four chamber view, apical long axis view and two chamber view by the thoracic echocardiography were obtained and stored. The original data was recorded and analyzed by using a novel off-line XStrainTM analysis software. The longitudinal/transversal systolic strain and strain rate values in16segments were acquired and compared. The above data had completed respectively by a high qualification doctor and a low qualification doctor. In order to perform pair wise comparisons. Statistical significance was taken as P<0.05and the statistical software was MedCalc, version19.0(MedCalc Software, Broekstraat52,9030Mariakerke, Belgium).ResultsThe baseline standard echocardiographic characteristics of44participants were shown in Table I. LVEDD, IVSD, IVPWD, LVEF were significantly higher in uremic patients than in that in controls. The longitudinal systolic strains and strain rates except for mid inferoseptal segment, the transversal systolic strains except for mid septal segment, the transversal systolic strain rates were lower in all segment, the differences were statistically significant (P<0.05). Compared with controls, the global longitudinal and transversal systolic strains were lower, the differences were statistically significant (P<0.05). ICC plots showed the95%limits of agreement were0.928,0.724,0.945and0.993, respectively, the greater the ICC value, the better the repeatabilityConclusionXStrainTM could clearly and comprehensively display the three-dimensional LV dynamics by building full volume image of LV, therefore can be useful for evaluating the LV regional and global systolic function in uremic patients. The dependence of the operator expertise was reduced. Meanwhile, It is helpful for primary hospitals to carry out clinical investigation without using the volume probe.