| Objective: To study left ventricular myocardial twisting motion and circumferential strain of different layers(i.e., subendocardium and subepicardium) in patients at different stages of chronic kidney disease(CKD) using ultrasonic velocity vector imaging(VVI), and to explore the mechanism of early cardiac function damages in patients with CKD. Methods: Twenty persons were employed as normal control group. One hundred two CKD patients were divided into four groups: group A(34 patients), group B(17 patients), group C(26 patients) and group D(25 patients). The dynamic three-dimensional(3D) images of apical four-chamber view were acquired and global LV ejection fraction(3D-LVEF) was obtained. The standard dynamic images of left ventricular short-axis view in basal and apical level in 3 consecutive cardiac cycle were collecting, by using the Syngo VVI workstation, the subendocardial and subepicardial myocardial rotation angle and circumferential strain and strain rate were analyized off-line. Results:(1)Compared with the normal group, Only LVEDD in group C was larger(P <0.05),and IVST in group C and D was thicker than that in the normal group.(2) In group C and D, the value of 3D-LVEF was less than that in the normal group.(3) CKD patients and normal persons had the same direction of rotation, the subendocardial rotation and circumferential strain were higher than those in subepicardial, apical rotation and circumferential strain were higher than that at basal.(4) Compared with the normal group, in group A, there were no significant changes in global rotation and circumferential strain(P>0.05), but the torsion angle increased at several segments, and several segments circumferential strain and strain rate reduced.In group B 〠C and D, along with reduced GFR, rotation and circumferential strain further reduced.(5) There were significant positive correlationships between the 3D-LVEF value and subendocardial and subepicardial myocardial rotation angle(r=0.66 and r=0.26, P<0.01). Conclusion:(1)VVI can detected systolic dysfunctionat at different stages of CKD.(2)Whether subendocardial or subepicardial, there were significant positive correlationships between the 3D-LVEF value and left ventricular torsion, and LV torsion could be used as an indicator of chronic kidney disease for the evaluation of left ventricular systolic dysfunction. |
