Echocardiography Evaluation Of Left Ventricular Function In Patients With Left Ventricular Hypertrophy Due To Chronic Kidney Disease And Primary Hypertension

Objective: To evaluate the left ventricular function in patients with left ventricular hypertrophy due to chronic kidney disease(CKD)and primary hypertension by using Echocardiography,and to compare the morphological structures of the heart,analyzes the diastolic and systolic functional changes of the left ventricle by conventional echocardiography and tissue Doppler ultrasound.Methods: 50 patients with CKD were carefully selected and divided into LVEF lowering group(LVEF<50%,Group A,20 patients)and LVEF normal group(LVEF ?50%,B group,30 patients)according to left ventricular ejection fraction(LVEF).Meanwhile,32 patients with essential hypertension(hypertension group/C group)and 30 patients in healthy control group were selected.The left atrial diameter(LAD),left ventricular end-diastolic diameter(LVDd),left ventricular end-systolic diameter(LVDs),inter-ventricular septum thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular mass index(LVMI)and left ventricular ejection fraction(LVEF)were measured by conventional Echocardiography.Mitral orifice diastolic peak systolic velocity ratio(E/A)in early and late stage was measured by pulse Doppler.Mitral ring and sidewall site peak systolic velocity Sa,early diastolic myocardial peak velocity Ea,and late diastolic myocardial peak velocity Aa were measured by tissue Doppler Ultrasound to calculate Ea/Aa and left ventricular Tei index.We compared the morphological structures and left ventricular function of the heart in each group.Results:1.Cardiac morphological structure: LAD,LVDd,LVDs,IVST,LVPWT,LVMI in group A,B and C were higher than the control group,LVMI in group A and B is higher than C group,statistically there is significant difference(P<0.05);there was no statistically significant difference in LVMI between group A and B(P>0.05).2.Diastolic function index: compared with the control group,E / A,Ea / Aa in group A,B and C significantly reduced,and groups C,B,A showed a decreasing trend(P<0.05).3.Systolic function index: Compared with the control group,LVEF onlysignificantly reduced in group A(P<0.05).Compared with normal control group,and the difference of LVEF in group B and C had no statistically significant(P>0.05);compared with the control group,Sa in group A and B decreased,and Sa in group A was lower than in group B(P<0.05).Although,Sa slightly reduced in group C compared with normal group,but the difference had no statistically significant(P>0.05).4.Overall function index: Compared with the control group,the left ventricle Tei index significantly increased in group A,B and C(P<0.05).The Tei index in group A was higher than group B and C(P<0.05).The Tei index in group B increased in comparison with group C,and there is statistically significant(P<0.05).Conclusion:1.Echocardiography can be used to evaluate cardiac morphological changes and left ventricular function of patients with CKD and primary hypertension.2.Both CKD patients and patients with primary hypertension had left ventricle hypertrophy,and the degree of hypertrophy of CKD patients was more serious than primary hypertensive patients.3.LVEF slow-down in Both CKD patients and patients with primary hypertension and left ventricular diastolic dysfunction was more serious for CKD patients.CKD patient's left ventricular systolic function has reduced before LVEF decreased.4.Both CKD patients and patients with primary hypertension,left ventricular overall function was normal,but for CKD patients the left ventricular function was more serious.The left ventricular overall function of CKD patients in LVEF lowering group was more obvious than LVEF normal group.