Right Ventricular Systolic Function In Uremic Hemodialysis Patients By Two-dimensional Speckle Tracking Technique Research On Application Value

Objective Two-dimensional speckle tracking imaging(2D-STI)was used to evaluate right ventricular function in uremic patients undergoing hemodialysis,and its application value in evaluating right ventricular function was preliminarily discussed.Methods A total of 20 healthy controls and 20 uremia patients(uremia gro up)were involved in this study.General examination data on the two group s were collected..Ultrasound cardiogram was performed in uremic patients within 2 hours after dialysis.IE Elite color Doppler ultrasound diagnostic i nstrument Philips Company,USA)was used.S5-1 probe was used with fre quency ranging from 1.0 MHz to 5.0 MHz.The subjects were in the left la teral position and recumbent position,connected with the lead electrocardio gram in front of the chest,followed by routine echocardiography.Subjects with left ventricular ejection fraction greater than 50% were selected for fol low-up study.Right ventricular end-diastolic volume(RVEDV),right ventric ular end-systolic volume(RVESV),right ventricular stroke volume(RVSV),right ventricular fractional output(RVCO)and right ventricular ejection fra ction(RVEF)in uremic patients were obtained by double-plane Simpson m ethod on the four-chamber and two-chamber sections of right ventricle.Long itudinal displacement curves of tricuspid annulus relative to apex in two-chamber and four-chambe views of right ventricle were obtained by using 2DSTI technique.The corresponding maximum longitudinal displacement(Ds)and its percentage(Dm%)of the distance from apex to the midpoint of the annulus were obtained and correlation between RVEF and the systolic pe ak value(FTADmid,TTADmid)at the midpoint of the four-chamber and t wo-chamber cardiac views and its percentage of Ds(FTADmid,TTADmid%)was analyzed by the least square method.Results(1)The RVEDV,RVESV,RVSV and RVCO of uremic patients were higher than those of the control group(P<0.05).(2)The RVEF of uremic group was less than that of the control group(P<0.05)(3)The peak systolic value(TADfre),the peak systolic value(TADsep),the peak systolic value(FTADmid)at the midpoint of the annulus commissurae and the percentage of FTADmid% to Ds were all lower in the uremic group than those in the control group(P<0.05);The peak systolic time(TADant),the peak systolic time(TADpos),the peak systolic time(TTADmid)at the midpoint of the annular junction and the percentage of TTADmid% to Ds in the two chambers were lower than those in the control group(P<0.05).(4)The correlation coefficients of RVEF with FTADmid,FTADmid,TTADmid and TTADmid% in uremia group and control group were0.910,0.922,0.844 and 0.841,0.834,0.842,0.783 and 0.772 respectively(P <0.01),and there was a strong correlation between them.Conclusions 1.The right ventricular spatial index(RVSI)is closely related to the myocardial toxicity damage and the increase of cardiac load after hemodialysis in uremic patients.2.The sensitivity and reliability of RVEF combined with tricuspid annular displacement in assessing right ventricular systolic function in uremic patients were increased.3.When EF of left ventricle and right ventricle is retained in uremic patients,the displacement of tricuspid annulus can prompt the decrease of right ventricular systolic function one step earlier.4.Two-dimensional speckle tracking technique can be used as an effective means to evaluate right ventricular systolic function in uremic patients.