Research On The Applications Of Cardiovascular Function Evaluation For Patients With Kidney Transplantation By The Instantaneous Wave Intensity

Purpose:The aim of the present study was to investigate the use of Wave Intensity(WI) as a new tool to assess left ventricular function and specified arteryelasticity condition for the evaluation of the early myocardial damage andcardiac artery adaptive function non-invasively in patients with renalhypertension.Methods:Thirty-two patients (male17, female15; age19-68years, mean age43.16士2.32years) with renal transplantation in stable medical condition andthirty-two health volunteers (male16, female16; age20-65years, mean age41.22士2.18years) as control were included in this study. All patients weregrouped into a postoperative complication group (7patients with high bloodpressure,>140/90mmHg;6patients with high blood sugar,≥7.0mmol/l) and anon-complication group (19patients). Cardiac function assessmentAllultrasound WI and heart function measurement was performed using a clinicalultrasound scanner with Adult program (Prosoundα10，ALOKA, Tokyo,Japan). Left ventricular end-systolic diameter (LVEDS), left end-diastolicdiameter (LVEDD), interventricular septum end-diastolic thickness (IVST), leftventricular post wall thickness (LVPWT), ejection fraction (EF), fractionalshortening (FS), stroke volume (SV) and cardiac output (CO) were evaluated.The peak early filling (E-wave) and the late diastolic filling (A-wave) velocities, and the E/A ratio was calculated. The all patients were measured three times totake the average, stored images and recorded data. Area of the negative waveduring mid-systole (NA), amplitude of the peak during late systole (W2),arterial stiffness (β), pressure-strain elasticity coefficient (Ep), arterialcompliance (AC), pulse wave velocity β (PWVβ). An independent t-test wasperformed to examine the difference in groups.Results:There was no statistically significance difference in age, height, weight,body surface area(BSA) and body mass index(BMI) between the postoperativecomplication group, the non-complication group and control (p>0.05). Thedifference of systolic pressure, diastolic pressure and mean artery pressure werestatistically significance in the postoperative complication group, comparedwith the non-complication group (p<0.01). Cardiac function assessmentThere was statistically significance difference for LVEDS, LVEDD, IVST andLVPWT among3groups (p<0.05). But there was no statistically significantdifference between the non-complication group and control. There was nostatistically significance difference for EF, FS, SV, CO, E/A and the latediastolic filling (A-wave) velocity among3groups, only for the peak earlyfilling (E-wave) velocity (p<0.05). Ultrasound elastography β、Ep andPWVβ in the postoperative complication group and the non-complication groupsignificantly increased (p<0.05), compared with control. W1、W2、NA in thepostoperative complication group significantly increased (p<0.05), compared with the non-complication group. There was no statistically significantdifference for AC and AI among3groups.ConclusionsWave intensity (WI) is a new hemodynamic index that providesinformation about the dynamic behavior of the heart and the vascular systemand their interaction. WI was obtained at the right carotid artery using a colorDoppler system for blood velocity measurement combined with anecho-tracking method for detecting vessel diameter changes with respect totime for assessing compliance of artery and elasticity and heart function. Wecan conclude from our study results that WI is expected to help pave the wayfor analysis of the interference between the heart and the arterial system inassessment of the patient condition.