Assessment Of Left And Right Ventricular Function By Two-dimensional Strain Imaging In Patients With Chronic Renal Diseases Of Different Stages

Objective: To observe the value of two-dimensional strain (2DS) in evaluatingleft and right ventricular function in patients with chronic kidney diseases.Methods:107patients with chronic kidney diseases examined by2DS weredivided into3groups, group A （GFR≥60ml／min／1.73m2，CKD stage1～2,n=30,m=16,f=14）,group B（GFR:59～30ml／min／1.73m3，CKD stage3，n=32，m=17，f=15）and group C（GFR≤29ml／min／1.73m3，CKD stage4～5，n=45，m=24，f=21）.32healthy subjects were examined as control. All the patients and controlswere determined left ventricular end diastole dimension(LVIDd), left ventricular endsystole dimension(LV-IDs), right ventricular end diastole dimension(RVIDd) byconventional echocardiography, and left ventricular ejection fraction(LVEF) which wasmeasured by Simpson’s rule. Four-chamber apical views, Two-chamber apical viewsand left ventricular long-axis views of two-dimensional images were stored. Thelongitudinal strain (S), longitudinal strain rate（SRs）and early diastolic strain rate (SRe)of left and right ventricular segments were derived by2DS software.Results:1.The LVIDd, LVIDs, RVIDd of group C were significantly decreased.Compared with the healthy controls, the IVSd of group B and C were reduced.2. Inright ventricle, the S, SRs and SRe in some segments of group A were obviously lowerthan the controls. Compared with the controls, The S and SRe of each wall of leftventricle in group B was decreased, except the S of the cardiac apex of anteroseptal walland the basal segment，the cardiac middle segment of inferior wall. The S and SRe of allsegments in group C were significantly lower than the controls. Compared with the thegroup A, the SRe of each wall of left ventricular in group C was decreased, except thethe cardiac middle segment of anterior wall and the cardiac apex of inferior wall.3. Inright ventricle, the longitudinal strain (S) and early diastolic strain rate (SRe) of all segments in group B were significantly lower than the controls. The SRs in mostsegments of group B were decreased. The SRs of all segments in group C weresignificantly lower than the controls. The SRe in most segments of group A weredecreased.4. GLS of group B and group C were significantly lower than the controls.The GLS of left ventricle had positive correlation with GFR.Conclusion:1. The systolic and diastolic function of left and right ventricularregional myocardial were significantly decreased in different degree in patients withchronic kidney diseases of stages1，2. But the integral systolic function of left and rightventricle were not reduced.2.The integral systolic and diastolic function of left andright ventricle were significantly decreased in patients with chronic kidney diseases ofstages3.3. The regional and integral systolic and diastolic function of left and rightventricle were significantly reduced in patients with chronic kidney diseases of stages4,5. Some segments of group C were significantly lower than group A.4. The GLS ofleft and right ventricle had positive correlation with GFR.5.2DS is more sensitive indetecting abnormal left ventricular systolic function than LVEF. The left and rightventricular function of the patients with chronic kidney diseases can be early,sensitively, accurately studied with2DS.