Evaluation Of Left Ventricular Regional Systolic Function In Patients With Early Chronic Kidney Disease By Three-dimensional Speckle Tracking Echocardiography

Objective: To evaluate left ventricular regional systolic function in patients with early chronic kidney disease(CKD)using three-dimensional speckle tracking echocardiography(3D-STE).Methods: applied three-dimensional speckle tracking imaging technology to analyze the left ventricular regional systolic function of patients with chronic kidney disease in the CKD2 group,CKD3 group and normal control group.The kidney was selected from June 2017 to September 2018 in our hospital.40 patients with stable CKD early pregnancy and 26 healthy volunteers(control group)were divided into CKD2,CKD3 and control group according to glomerular filtration rate,of which CKD2 20 for example,20 patients with CKD 3 and 26 patients with normal control group underwent conventional two-dimensional echocardiography and three-dimensional speckle tracking imaging.The analysis indexes were left ventricular systolic area strain(SAS),systolic circumferential strain(SCS),systolic longitudinal strain.(SLS),and systolic radial strain(SRS),compare the differences between the parameters of each group,and evaluate the changes of left ventricular regional myocardial contractile function in patients with CKD.Results:SLS results: There was no difference in SLS strain between the apex and the bascallateral(BL)of the left ventricular myocardium in the CKD stage 2 group with the control group(P>0.05).The SLS strain values of the other segments were lower than those in the control group.(P<0.05);CKD stage 3 and CKD stage 2 patients with left ventricular myocardium apicalanterior(AA),apicalinferior(AI),midseptum(MS),basalanteroseptal(BAS),basalinferior(BI),basalposterior(BP),and basalseptum(BS),there was no difference in SLS strain value(P>0.05),and the SLS strain values of other segments were lower than those in CKD2 group(P<0.05).Compared with the control group,CKD3 group had myocardial SLS strain values in all segments of left ventricle myocardium,both were reduced(P<0.05).SAS results: Compared with the control group,there was no difference in SAS strain between the apex,apicalanterior(AA),midanterior(MA),midseptum(MS),and basallateral(BL)(P>0.05).The myocardial SAS strain values in the other segments were lower than those in the control group(P<0.05).The CKD3 group and the CKD2 group had the left ventricular apicallateral(AL),midanteroseptal(MAS),midinferior(MI),midposterior(MP),basalanterseptal(BAS),basalinferior(BI),basalposterior(BP),basalseptum(BS),there was no difference in SAS strain between this two group(P>0.05).The remaining segmental myocardial SAS strain values were lower than the CKD2 phase group(P< 0.05);Compared with the control group,the SAS strains of all segments of the left ventricular myocardium were decreased in the CKD stage 3 group(P<0.05).SCS results: CKD stage 2 compared with the control group,the left ventricular apicallateral(AL),apicalseptum(AS),midinferior(MI),basalanterior(BA),basalanteroseptal(BAS),basallateral(BL),and basalposterior(BP),SCS strain value was significantly reduced(P<0.05);CKD stage 3 group compared with CKD2 group,left ventricular apex,apicalanterior(AA),apicalinferior(AI),apicalseptum(AS),midanterior(MA),midinferior(MI),midposterior(MP),the myocardial SCS strain values in the middle segment and the posterior wall segment were significantly decreased(P<0.05).There was no difference in SCS strain values in midanteroseptal(MAS)between the CKD phase 3 group and the control group(P>0.05).The other SCS strain values were lower than the control group(P<0.05).SRS results: CKD stage 2 group compared with the control group,the left ventricular apicallateral(AL),midanteroseptal(MAS),midinferior(MI),midposterior(MP),basalanterior(BA),basalanteroseptal(BAS),basalinferior(BI),basallateral(BL),and basalposterior(BP)were significantly decreased(P<0.05).The CKD3 group was compared with the CKD2 group in the left ventricular myocardium,the myocardial SRS strain values of the apex,apicalanterior(AA),apicalinferior(AI),apicalseptum(AS),midanterior(MA),midlateral(ML),midseptum(MS),basalanterior(BA),and basallateral(BL)were significantly reduced(P<0.05).Compared with the control group,the CKD stage 3 group had lower myocardial SRS strain values in all segments of the left ventricle myocardium(P<0.05).CKD stage 2 group and control group,apicallateral(AL),apicalseptum(AS),midanteroseptal(MAS),midinferior(MI),basalanterior(BA),basalanteroseptal(BAS),basalposterior(BP),strain values were significantly reduced in SLS,SAS,SCS,SRS(P<0.05);CKD phase 3 and CKD2,apex(Apex),apicalseptum(AS),midanterior(MA)of the anterior wall was significantly reduced in SLS,SAS,SCS,and SRS(P<0.05),and there were more segmental differences in longitudinal strain.Conclusion:3D-STE can be used to evaluate the left ventricular regional systolic function in patients with early CKD,and SLS is a sensitive index.