The Clinical Study Of Three-dimensional Speckle Tracking Technique For Evaluation Of Left Ventricular Systolic Function In Patients With Chronic Renal Insufficiency

Objective: To explore the value of three-dimensional speckle tracking technology(3D-STI)in evaluating the left ventricular systolic function in patients with chronic renal insufficiency(CKF),and to provide an objective and convenient new method for clinical diagnosis and the evaluation of myocardial damage in patients with chronic renal insufficiency.Methods:In Mengyin County People's Hospital,50 of the patients with chronic renal insufficiency from 2016.01 to 2017.01 were selected,including 33 men and 17 women,which were all in accordance with the diagnostic criteria of chronic renal insufficiency in the2002 guidelines for the clinical diagnosis and treatment of chronic kidney disease in the United States and excluded from the diabetes,coronary heart disease,myocardial infarction and primary disease.Hypertension and other diseases cause cardiac structural changes and poor image quality.First,the left ventricular ejection fraction of the patients with chronic renal insufficiency was measured.According to the left ventricular ejection fraction(=55-65%),the patients with chronic renal insufficiency were divided into EF normal group and EF abnormal group.There were 31 cases of normal EF,and 19 abnormal EF.Another 50 healthy volunteers were randomly selected as control group.GE Vivid E9 ultrasonic detector(US General Company)M5S and 4V two kinds of probe were used to perform routine and three-dimensional echocardiographic examination on chronic renal dysfunction group and control group.The data were analyzed by 4V software of ECHOPAC workstation,and 4D Auto LVQ was used,and three dimensional dot tracking was used to start the heart automatically.The image obtained by the tip is analyzed.The software can generate a number of images of the apical four cavity,the two cavity and the left heart long axis view,and adjust the position of the cutting line to obtain the four cavity of the apex,the two cavity and the left heart long axis,and determine the position of the apex and the bottom of the ventricle,and select the better quality four cavity or two cavity image,in the end diastolic end of the heart.At the end of the systole and the end of the systole,each point is selected respectively.The software will automatically trace the boundary of the left ventricular endocardium and the epicardium,and automatically track the three-dimensional movement of the inner muscle in the region of interest to obtain valuable information.After that,the system will automatically adjust the correlation data to obtain and compare the patient's heart.The left ventricular ejection fraction(LVEF)and longitudinal strain(GL),circumferential strain(GC)and radial strain(GR)of the left ventricular global peak were measured.Results:(1)there was no significant difference in the age,BMI BMI and diastolic pressure in the normal group of chronic renal insufficiency EF,the abnormal EF group and the control group(P>0.05).Compared with the control group,the difference in systolic pressure,serum creatinine,BUN and GFR in normal EF group and EF abnormal group was statistically significant(P<0.05);EF normal Compared with the EF group,there was no significant difference in systolic blood pressure,serum creatinine,BUN and GFR(P>0.05).(2)The left ventricular ejection fraction(LVEF)in the abnormal group of the patients with EF was decreased,and the GL,GC,and GS of left ventricular systolic phase were all decreased,and the difference was statistically significant(P<0.05).(3)When the left ventricular ejection fraction(LVEF)of the normal group of the patients with insufficiency EF was still in the normal range,the GL,GC,and GR were all decreased,and GL was significantly lower than the normal control group,and the difference was statistically significant(P<0.05).(4)GL,GC,and GR of the patients with chronic renal insufficiency EF in the normal group were significantly lower than those in EF normal group,and the difference was statistically significant(P<0.05).(5)There was a good correlation between GL,GC,and GR of the overall peak of the left ventricular systolic phase and the left ventricular ejection fraction(LVEF)in two groups of patients with chronic renal insufficiency(r = 0.781,0.679,0.709,all P < 0.05).GL,GC,and GR decreased as LVEF decreased.Conclusion: 3D-STI can be used to evaluate left ventricular systolic function in patients with chronic renal insufficiency.It is simple,accurate,rapid and reproducible.At the early stage,when the left ventricular ejection fraction was normal,the total left ventricular peak strain parameters showed subclinical hypothyroidism in the myocardial contractile function,and the longitudinal peak strain parameters were more sensitive.The 3D-STI application was used to evaluate the abnormal left ventricular systolic function in the patients with chronic renal insufficiency,made up for the deficiency of other techniques for early detection of myocardial damage.