Assessment Of Right Atrium Volume And Right Ventricular Function Of Chronic Kidney Disease Based On Three Dimensional Echocardiographic And Tissue Doppler Technique

Objective To evaluate right atrium volume and right ventricular function in patients with chronic kidney disease(CKD)by full volume three dimensional echocardiographic(FV3DE)and tissue Doppler technique(TDI).Methods 30 control subjects and 60 patients with CKD,which were divided into Ia group(CKD1 to 3)and Ib group(CKD4 to 5).Systolic and diastolic velocity of tricuspid annulus were measured in apical 4 chamber views by PW-TDI:peak systolic velocity(Sm),peak early diastolic velocity(Em),peak late diastolic velocity(Am),and calculate Em/Am.FV3DE data of 60 patients with CKD and 30 normal controls were acquired and analyzed.Minimum volume(Vmin),maximum volume(Vmax)and pre-contraction volume(Vp)of right atrium(RA)were measured.and then RA reservoir volume(RV),active emptying volume(RAVae)and RA active emptying fraction(RAEF),emptying fraction(RAVpef)were calculated.Tricuspid annulus plane systolic excursion(TAPSE)was obtained by M-mode.The parameters obtained by ultrasonic techniques were compared between CKD group and control group.The intra-and inter-observer reliability of 3DE was assessed by Bland-Altman method and intra-class correlation coefficient(ICC).Results ?The RAVmax?RAVmin?RAVp?RV as well as RAVae and Am were larger in CKD group than control group significantly,Em?Em/Am?RAVpef were significantly lower in CKD group than those in group II(P<0.05).The difference of the Sm?RAEF and TAPSE between them were not significant(P>0.05).?The Sm and RAVpef of group Ib was lower than those in group Ia,The RAVmax?RAVmin as well as RAVae of group Ib was larger than those in group Ia.Difference between them was significant(P<0.05).Em?Em/Am?Am?RV?RAVp as well as RAEF and TAPSE were not significant between them ?There was strong negative relation between RAae and Em/Am(r=-0.902,P=0.000),there was negative relation between RAae and Sm as well.(r=-0.684,P=0.000).?The reproducibility of 3DE technique was well.Conclusion The ultrasonic techniques,such as FV3DE and TDI,could be used to assess right atrium volume,function and right ventricular function,which could be consider as an effective method and parameter for detecting cardiovascular complication and improving prognosis of chronic kidney disease.