The Change Of Systolic Function And Synchronicity Of Left Ventricle In Patients With Uremic In Different Dialysis Time Using Real-time Three-dimensional Echocardiography

Objective：To evaluate the change of the structure and systolic function andsynchronicity of left ventricular in patients associate with uremic indifferent dialysis time according to real-time three-dimensionalechocardiography.Analyse the variation tendency with the time ofhemodialysis.Methods：105UM patients chosen from China-Japan Union Hospital of JilinUniversity Hemodialysis Center which are duing long-term blood dialysistherapy，divide the UM patients into different groups by the time ofhemodialysis:<1year(Group A),≥1year and≤3year（Group B），>3year（Group C）；control group choose30healthy people from medicalexamination in the same time as normal group(Group N);Each group hasexclude congenital heart valve disease,congenital heart disease,ischemicheart disease and any kinds of myocardiopathy by echocardiography,andatrial fibrillation or other kinds of arrhythmia byelectrocardiogram(ECG).Using normal echocardiography to measure leftatrial diameter(LAD)， interventricular septum diastolicdimension(IVSd),left ventricular end-diastolic dimension(LVEDd),LeftVentricular Posterior Wall Depth(LVPWd),left ventricular ejectionfraction(LVEF),left ventricular fractional shortening (LVFS).Usingreal-time three-dimensional echocardiography (RT-3DE）collect images of the four cavity heart standard section and synchronous connect ECGwith the one same sonographer.Put all the images into Qlabsoftware,apply3DQAdvanced function measure end diastolic velocity（EDV）,end Systolic volume（ESV）, automatically come up with strokevolume（SV）and ejection fraction（EF%）.According to sequentialanalysis to get17segments of left ventricle time-volume synchronismcurve,standard deviation of left ventricle16segments,12segments,6segments time to minimal segmental volume（Tmsv16-SD、Tmsv12-SD、Tmsv6-SD）,and the difference （Tmsv16-Dif、 Tmsv12-Dif、Tmsv6-Dif),and the percentage of R-R interval （Tmsv16-SD%、Tmsv12-SD%、 Tmsv6-SD%、 Tmsv16-Dif/%、 Tmsv12-Dif%、Tmsv6-Dif%).With SPSS21.0statistical software analyse the data indifferent group,data expressed with a mean±standard deviation.P<0.05shows statistical significance.Results:Compared with control group,UM group had statisticallysignificant(P<0.05)in EDV、ESV、SV、IVSd、LVPWd、Tmsv16-SD、Tmsv12-SD、Tmsv6-SD、Tmsv16-Dif、Tmsv12-Dif、Tmsv6-Dif、Tmsv16-SD%、 Tmsv12-SD%、 Tmsv6-SD%、 Tmsv16-Dif/%、Tmsv12-Dif%、Tmsv6-Dif%; Group A compared with Group N had nostatistically significant（P>0.05）,other groups had statistically significant（P<0.05）；HR in Group B and Group C both higher than GroupN,Group C higher than Group A,all had statistically significant(P<0.05),Group B with Group A,Group C with Group B had nostatistically significant（P>0.05）.Between UM group ESV、EF、IVSd、LVPWd、 Tmsv16-SD、 Tmsv12-SD、 Tmsv6-SD、 Tmsv16-Dif、Tmsv12-Dif、 Tmsv16-SD%、 Tmsv12-SD%、 Tmsv6-SD%、 Tmsv16-Dif%、Tmsv12-Dif%had statistically significant(P<0.05);EDV、HR、Tmsv6-Dif、Tmsv6-Dif/%between Group A and Group B had nostatistically significant （P>0.05）,others had statistically significant（P<0.05）.SV in Group A with Group B,Group B with Group C had nostatistically significant（P>0.05）,Group A with Group C had statisticallysignificant（P<0.05）.Conclusion:①In UM group left ventricular septum get more thick than controlgroup,with more times hemodialysis the left ventricular septum get morethick.②Left ventricular volume in UM group higher than control groupand increasing with hemodialysis years get longer.③Left ventricularsystolic synchronicity in UM group lower than control group withhemodialysis times get declining.④Left heart function in UM grouplower than control group with hemodialysis times get declining.⑤RT-3DE RT-3DE is a rapid,simple, accurate and non-invasive tool forclinical medical to evaluate left heart function and mechanicaldyssynchrony of UM patients.