| Chronic Renal Failure (CRF) is the common consequences of primary or secondary renal lesions'continued Progress, and it is a syndrome which is usually irreversible. CRF is different from acute renal failure, which develops gradually from a long-term disease, and the damage of the kidney is irreversible, and the prognosis is poor. The incidence is about 0.5-1.0 behavior of the crowd, so CRF is one of the most serious diseases threatening the lives of human beings.Heart damage is the common and serious complications of patients with CRF, it is also the major cause of death. Among the heart damage, the change of cardiac structure and function have the highest incidence and usually appear first, 50% of patients with CRF died of cardiovascular diseases. So early comprehensive evaluation of the left and right ventricular structure and function in patients with CRF is the main purpose of this study. Lately, there are some reports of Left ventricular function in patients with CRF, because of the complex shape and the thinner wall of right ventricular, we are unable to accurately observe and evaluate the activities of the right ventricle, so the reports of right ventricle function are very few. And evaluation of the left and right ventricular function in Patients with CRF has not been reported. This study comprehensively evaluate left, right ventricular function of Patients with CRF by TDI and TDI-Tei index. Because it is simple, objective, non-invasive, reproducible and easierto accept, so it not only provide an accurate and objective diagnosis for the clinical evaluation of left and right ventricular function of patients with CRF, but also establish the foundations for further clinical treatment.1995, foreign scholar Tei C first proposed Tei index (Tei index), and applicated it in clinical. Tei index is the ratio of time interval, and it's not dependent on the geometry of the heart. The study also shown that Tei index has reported to be independent of two-dimensional images, heart rate, and blood pressure. In addition, studies have also shown Tei index is a feasible approach for the estimation of right ventricular function in patients with various heart diseases. Thus Tei index is a valuable indicator for evaluation the global cardiac function.Currently, most traditional measurement of Tei index is by Pulsed Doppler, and its flow time interval is not in the same cardiac cycle. and Tei index measured by Tissue Doppler Imaging (TDI) overcomes this shortcoming. TDI can observe atrial and ventricular movement directly, and record systolic and diastolic spectrum simultaneously. It can show moving velocity and direction of myocardial and analysis the cardiac function. so TDI is a new non-invasive ultrasound imaging method. Tei index obtained from the TDI also is independent of heart rate, blood pressure and cardiac geometry, it's measuring method is simple, repeatable, So TDI- Tei index is a very useful parameter for the overall evaluation of cardiac function. Furthermore, the study have shown that TDI can be used as an objective index of observing thewall movement velocity. By the analysis of regional wall motion spectrum, we find the characteristic changes of systole and diastole .In the past, there were some reports about evaluation of left ventricular function by TDI, in recent years, some scholars assess right ventricular function by TDI, So TDI can not only evaluate left ventricular function, but also can evaluate right ventricular function.The study used Aloka SSD 5500 ultrasonoscope with a tissue doppler imaging system. the group is consisted of 54 normal subjects and 52 patients with CRF, The diameter of the left atrium (LA), The systolic diameters of left ventricles (LVs) and interventricular septum thickness (IVSs), left ventricular posterior wall thickness (LVPWs), the diastolic diameters of of left ventricles (LVd) and interventricular sePtum thickness (IVSd), left ventricular posterior wall thickness (LVPWd) and right ventricle (RV) were measured by conventional echocardiography in the parasternal left ventricular long axis view in M mode. Peak systolic (S) and early peak diastolic velocity (Ea), late diastolic velocity (Aa) and Ea/Aa of mitral and tricuspid valve were acquired from the apical four-chamber view, while measuring the time interval from Q wave of electrocardiogram to the onset of E and TDI-Tei index to assess the function of left and right ventricular.The results of this study showed that the left and right ventricular Tei index of mitral and tricuspid in the patients with CRF was higher than that in control group, and Ea, Ea/Aa of mitral, tricuspid annulus, was significantly lower than the control group. mitral annular septal Speak significantly lower than the control group, the difference was significant. The study through the use of TDI and Tei index comprehensively evaluate the left and right vetricular function in patients with CRF, the results showed that CRF patients exist left ventricular systolic and diastolic dysfunction, meanwhile, there are right ventricular diastolic dysfunction. This study also showed that renal hypertension in patients with CRF is the major reasons of right ventricular diastolic dysfunction. LA, IVSd, LVd, LVPWd, IVSs. LVs and LVPWs in patients with CRF are higher than the control group, the difference was significant. RV had no obvious changes, which suggested that major structural damage of patients with CRF is its left ventricular.TDI and TDI-TEI index can not only comprehensively evaluate left ventricular function in patients with CRF, it can also evaluate right ventricular function early, even if there are no changes in systolic function, diastolic dyfunction can also be reflected earlier, because it is simple, objective, non-invasive, reproducible and easier to accept, so it not only provides an accurate and objective diagnosis for the clinical evaluation of left and right ventricular function of patients with CRF, but also establishs the foundations for further clinical treatment.
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