The Evaluation Of Left Heart Structure And Function In Uremia Patients With TDI-tei Index

Objective: We used two-dimensional ultrasound and TDI-Tei index to evaluate the left heart structure and function of uremia patients,and discuss the application value of the Tei index.Method:The clinical data were derived from 43 uremic patients who were treated in the Department of nephropathy and 52 normal medical examiners from December 2016 to February 2018.Measureed of the left atrium diameter,end systolic and end diastolic left ventricle of each person,and the thickness of interventricular septum and the thickness of the left ventricular posterior wall of each person at the end of systolic and late diastolic by routine ultrasound.In the apical four chamber cardiac section,we used pulse Doppler to obtain the mitral valve blood flow spectrum and measure the peak value of E and A.Then we used tissue Doppler(TDI)to measure systolic Sa wave,early diastolic and late diastolic Ea and Aa wave peak velocities.We measure the Tei index at the posterior segment of the mitral annulus for three times,and calculated the average value of the Tei index.Results:(1)The internal diameter of LAD,LVDd,LVDs,IVSd,IVSs,LVPWd and LVPWs in the uremia patients increased significantly compared with the control group(P < 0.05).(2)The abnormal diastolic dysfunction in uremia patients was E/A < 1,and there were significant differences between the normal group and case group(P < 0.05).The false normalization was 1 < E/A < 2,and there was no difference between the two groups(P > 0.05).(3)Compared with the control group,the values of Sa,Ea and Ea/Aa in the uremia patients were all decreased,and the value of Aa increased.The difference were significant(P < 0.05).(4)The TDI-Tei index of the patients with uremia was significantly higher compared with normal physical examination,and there was obvious differences between the normal group and case group(P < 0.05).Conclusion: The TDI-Tei index is an indicator of the overall function of the systolic and diastolic function of the heart,and the TDI-Tei index increases,suggesting a decrease in the overall function of left ventricular diastolic and systolic function.Tei index is not affected by image quality and ventricular morphology.It is convenient,time-consuming,repeatable and practical.It can be used as a simple,accurate and objective comprehensive evaluation index for clinical assessment of cardiac function in uremic patients.