Evaluation Of Left Ventricular Systolic Function In Patients With Renal Insufficiency Using Automated Cardiac Motion Quantification Technique And Three-dimensional Quantitative Analysis Technique

ObjectivesThe left ventricular systolic function in normal people and Chronic Kidney Disease patients were evaluated by echocardiography automated cardiac motion quantification(a CMQ)technique and three-dimensional quantitative analysis(3DQA)technique,To investigate the correlation between a CMQ technique and 3DQA technique for evaluating left ventricular systolic function and its clinical application value.Research methodsA total of 68 patients were enrolled in the Department of Nephrology in our hospital.All patients had abnormal renal function.Left ventricular ejection fraction(LVEF)was ?50% by echocardiography as the disease group.A total of 29 patients with normal renal function who matched their gender and age were selected as control groups in outpatient health examinations.According to the modified MDRD formula,the e GFR value of patients in the Department of Nephrology was calculated.First,the disease components were graded from CKD 1 to 5 according to different e GFR values.This study was divided into four groups.The first group was defined as normal kidney function group,consists of normal controls.The second group was a group with mild renal impairment,consisting of patients with CKD Stage 1 and Stage 2.The third group consisted of a moderately impaired renal function group consisting of patients with CKD stage 3.The fourth group was a group with severe renal impairment,consisting of patients with CKD stage 4 and stage 5.The use of conventional echocardiography,a CMQ technology and 3DQA technology to observe the structure,function and blood flow,and analyze and record the data of the subject.Routine echocardiographic data included Left atrial(LA),Leftventricular inner dimension in end diastole(LVIDd),left ventricular internal diameter at end-systole(LVIDs),Interventricular septum(IVSd),and Left ventricular post wall(LVPW).Left ventricular ejection fraction(LVEF),left ventricular mass(LVM)and left ventricular mass index(LVMI)were calculated.The a CMQ technical record data includes left ventricular end-diastolic volume(EDV),left ventricular end-systolic volume(ESV),left ventricular ejection fraction(LVEF),left ventricular Globa1 1ongitudinal strain(LVGLS),left ventricular apical two-chamber 1ongitudinal strain(LVAP2LS),left ventricular apical three-chamber 1ongitudinal strain(LVAP3LS),left ventricular apical four-chamber1 ongitudinal strain(LVAP4LS),left ventricular Globa1 Circumferential strain(LVGCS),left ventricular short-axis base Circumferential strain(LVSAXBCS),left ventricular short-axis mid Circumferential strain(LVSAXMCS),left ventricular short-axis apical Circumferential strain(LVSAXACS);3DQA technical record data includes: LVEDV,LVESV,LVEF,three-dimensional displacement of Left ventricular overall and each segment.Results1.Comparison of the general situation: The body surface area,systolic blood pressure and diastolic blood pressure of the 4 groups were statistically significant(all P<0.05).2.Comparison of biochemical indicators:The creatinine,urea nitrogen,potassium in blood,uric acid,parathyroid hormone and Phosphorus in blood increaseded,Blood calcium,Hemoglobin and albumin of the 4 groups were statistically significant(all P<0.05).3.Comparison of conventional echocardiographic measurements: LA,LVDd,LVDs,IVSd,LVPW,LVM,LVMI,LVEF of the 4 groups were statistically significant(all P<0.05).4.Comparison of a CMQ technology measurements: LVEDV,LVESV,LVEF,LVAP3 LS and LVGLS of the 4 groups were statistically significant(all P<0.05).5.Comparison of 3DQA technology measurements: EDV,ESV,LVEF,threedimensional average displacement,interval Apical segment displacement,Left atrial wall apical segment displacement and left ventricular apex displacement of the 4 groups were statistically significant(all P<0.05).6.The a CMQ technique and 3DQA technique were positively correlated with LVEF,LVEDV,and LVESV(r = 0.73,0.91,0.92,all P <0.01).The 3DQA technique showed a positive correlation between LVEF and three-dimensional mean displacement(r = 0.662,P<0.01);Negative correlation with LVGLS(r =-0.815,P <0.01),the lower the LVEF,thesmaller the absolute value of LVGLS.Conclusion1.With the deteriorating renal function,left ventricular remodeling is aggravated and left cardiac function is gradually reduced.2.The Left ventricular ejection fraction measured by the a CMQ technique and the3 DQA technique have a high EF correlation and both can accurately evaluate left ventricular systolic function.3.The left ventricular systolic function was assessed early by the a CMQ technique and the 3D QA technique was used to measure left ventricular global longitudinal strain.The displacement of the three-dimensional apical segment responded earlier to left ventricular systolic function than other segments.