Two-dimensional Speckle Tracking Imaging For Assessment Of Left Ventricular Systolic Function In Uremic Patients Before And After Peritoneal Dialysis

Objective:To evaluate the left ventricular systolic function of each segment in uremic patients before and after peritoneal dialysis by two-dimensional speckle tracking imaging. Discussion the clinical value of the two-dimensional speckle tracking in evaluating of left ventricular function in patients with uremia. Methods:30 cases of uremic patients who have been diagnosed by Nephrology of First Hospital of Shanxi Medical University were collected. All patients have not been received dialysis. And their LVEF>50% by Conventional echocardiographic examination. While collecting 30 cases healthy control group, whose age, sex and weight matched with uremic patients. Their general information such as gender, age, height, weight, blood pressure, heart rate and so on were be record. Uremic patients and the control group got a echocardiographic examination, and the patients with uremia were checked again after peritoneal dialysis 3-6 months. Conventional two-dimensional echocardiography was used to measure left atrial anterior and posterior diameter(LAAPD), interventricular septum thickness(IVST), left ventricular posterior wall thickness(LVPWT), left ventricular end diastolic diameter(LVEDD), left ventricular end systolic diameter(LVESD), left ventricular end diastolic volume(LVEDV), left ventricular end systolic volume(LVESV) and ejection fraction(LVEF). Left ventricular motion pictures were captured which include two chamber, three chamber and four chamber of apical and three short axis views. The time-strain curve of 16 myocardial segments were obtained through Qlab software, and then the peak systolic strain were measured. Analyze the left ventricular systolic dysfunction in uremic patients before and after peritoneal dialysis. Results:(1) Comparison between uremia group(without dialysis) and control group:(1)systolic arterial pressure, diastolic arterial pressure and pulse pressure of Uremic patients increased, the difference was statistically significant(P<0.05), the systolic arterial pressure, diastolic arterial pressure and pulse pressure of uremic patients increased.(2) LAAPD, LVEDD、LVESD、LVEDV、LVESV and LVMI on patients with uremia were larger than control group, while IVST, LVPWT and RWT were thicker(P<0.05).(3) The longitudinal, radial and circumferential directions peak systolic strain of 16 Segment myocardial between two groups have statistically differences(P<0.05).(2) Comparison between uremic patients before and after dialysis:(1) The systolic arterial pressure of uremic patients decreased after dialysis(P<0.05).(2) LAAPD and LVMI of uremic patients decreased after dialysis(P<0.05).(3) The BAS, BA, BIL, BI, BIS, MAS, MAL, MIL, APA, APL longitudinal systolic peak strain and the BAL, MAL, MIS, APS, APL, API radial systolic peak strain of uremic patients increased after dialysis(P<0.05). There were no statistical difference of Circumferential peak systolic strain. Conclusion:(1) Each segment myocardial function of the left ventricle in uremic patients decreased. Part of the myocardial systolic function improved after short-term peritoneal dialysis.(2) Two-dimensional speckle tracking technology can make a quantitatively and objectively evaluate left ventricular systolic function in uremia before and after dialysis.