The Left Ventricular Function Evaluated By Real-time Three-dimensional Echocardiogram In Patients Of Maintenance Hemodialysis With Secondary Hyperparathyroidism

Objective： Application real-time three-dimensional echocardiography(real-time three-dimensional echo-cardiography, RT-3D) time-Volume curve(Volume-time Curves, the VTC) and displacement-time parameter imaging(Illustration of the Bull Eyes, IBE) maintenance hemodialysis evaluation withSecondary hyperparathyroidism (Secondary hyperparathyroidism, SHPT)patients left heart function and the value of the synchronicity.Method：Choose according to echocardiography within one week beforethe blood qing PTH value size, will object into A B group two group, A groupof "three times the normal cap, group B> normal limit three times, and eachgroup of each25cases according to age and gender and A group B patientsmatched25cases of normal control group measure left room left ventricularseptal thickness after the left ventricular wall thickness, left ventricularmyocardial weight index and Tei index application RT-3D VTC and IBEtechnology maintenance hemodialysis evaluation with secondaryhyperparathyroidism patients left heart function and synchronicity.Result:1.The group left room inside diameter and thickness left ventricular septalwall thickness, left ventricular myocardial weight index and the measured valueof the Tei index are larger than normal control group, the difference wasstatistically significant (p <0.05); Group A lower than the value of group B, thedifference was statistically significant (p <0.05) A B two group of M XingXinfunction (M-EF) RT3D heart function (3D-EF) measured value comparedthan normal, the difference was not statistically significant (p>0.05), A group of M-EF3D-EF and group B is measured values, the difference was notstatistically significant (p>0.05).2. A group of normal control group corresponding curve segment comparison,VTC curve form all not neat, part of irregular curve each other crisscross, eachsegment of the contraction curve minimum volume of the time point is irregular,high and low amplitude differ, show that A B two groups of all appearventricular systolic not synchronous changes.Group A and B group in left ventricular12segment end systolic minimumvolume time standard deviation maximum difference and heart rate is at school,the group B Tmsv12-SD Tmsv12-Dif Tmsv12-SD/R-R%Tmsv12-Dif/R-R%are higher than the group A, the difference was statistically significant (P <0.05), the more the left ventricular segmental curve more, two groups ofdifference was statistically significant results show that group B is A group of12in left ventricular segmental VTC contraction curve more divergence.3. The normal control group IBE parameters in Excursion-Max Excursion-Minis A B two group of numerical low, the difference was statistically significant (P<0.05), and A B two set of values is the difference was statistically significantgroup B Excursion-Avg A group A normal control group numerical high, thedifference was statistically significant (P <0.05), A group of normal controlgroup and the measured value was statistically significant (P <0.05)Excursion-SD measurements in group A group B and between normal controlgroup were no statistically significant (P>0.05) normal control group timingfigure left entricular17section is shrinking synchronous (all showed that forthe green), displacement figure left entricular each segment movementdirection, displacement difference is small (all showed that blue) and A group Btiming figure shows left ventricular segmental systolic17synchronization, partof the segment occurrence systole delay (both in red), displacement figure leftentricular each segment movement direction not coordinated and displacement bigger, part of the difference in the section moving range reduced two bovineeye chart can visual display A B two groups of patients with left ventricularsegmental contraction delay and part of the segment contraction activityweakens.Conclusion:1. Maintenance hemodialysis patients with secondary parathyroid thereexists different degree of heart structure and function of the damage, and withthe parathyroid hormone level increases, the structure and function of the heartof the damage is then increase.2. RT-3D time-volume curve can be more accurate evaluationmaintenance hemodialysis patients in different parathyroid hormone levels leftventricular movement synchronicities, patients for clinical evaluation of thecurative effect and provide a new method.3. RT-3D displacement-time parameter imaging bovine eye chart can bemore visual display of left ventricular segmental contraction of the17synchronicity, clinical evaluation for early maintenance hemodialysis uremiawith secondary hyperparathyroidism patients left ventricular movement toprovide more intuitive consistent synchrony new method.