Evaluation of left ventricular function in uremic patients undergoing long-term peritoneal dialysis by myocardium layerspecific strain and myocardial work
SHI Fei1, PAN Chun2, WU Yanni1, TANG Chao1, FENG Sheng3, ZHU Jing1
(1. Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou Jiangsu 215004; 2. Department of Critical Care Medicine, Zhongda Hospital, Southeast University, Nanjing Jiangsu 210009; 3. Department of Nephrology, The Second Affiliated Hospital of Soochow University, Suzhou Jiangsu 215004, China)
Abstract：［Abstract］Objective： To describe the left ventricular function of uremia patients with longterm peritoneal dialysis by application of myocardial layerspecific strain analysis and myocardial work techniques, and to evaluate the changes of myocardial function under longterm peritoneal dialysis. Methods： A total of 14 patients with uremia who underwent peritoneal dialysis regularly and whose left ventricular ejection fraction (LVEF) was normal by routine echocardiography were enrolled in the study. Routine two-dimensional echocardiographic parameters were measured. Left ventricular global longitudinal peak systolic strain (GLS) and the longitudinal peak systolic strain (LS) of the endocardium (LSendo), myocardium (LSmyo) and epicardium (LSepi) were measured by twodimensional speckle tracking imaging (2DSTI) and myocardial layerspecific strain analysis. Combined with blood pressure, the overall work parameters of the left ventricular myocardium were obtained to jointly evaluate the myocardial function of the left ventricle. The patients were followed up for 5 years and compared before and after 5 years of peritoneal dialysis. Results： After 5 years of regular peritoneal dialysis, there was no statistical difference in the change of LVEF in uremia patients, GLS significantly decreased in the four-chamber plane of the heart (P=0.018), and decreased from endocardium to epicardium (LSendoP=0.029, LSmyoP=0.017, LSepiP=0.004); global work parameters were mainly increased in global wasted work (GWW, P=0.048), but there were no significant differences in global constructive work (GCW), global work index (GWI) and global work efficiency (GWE). Conclusion： In uremia patients with longterm regular peritoneal dialysis for 5 years, the overall myocardial function of the left ventricle remained stable, but the local myocardial systolic function was further impaired, mainly evidenced by decrease of the myocardium of the posterior septum and lateral wall, and the myocardial work was dominated by elevated GWW.
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收稿日期: 2022-08-19
基金资助:江苏省卫健委重点课题(ZD2021057)； 苏州市科技计划项目(SYS2020136)
通讯作者:
朱静(通讯作者)，副主任医师，E-mail: 15051408537@163.com
作者简介: 石菲(1993—)，女，硕士，住院医师，主要从事心血管疾病的研究
引用本文:
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SHI Fei1, PAN Chun2, WU Yanni1, TANG Chao1, FENG Sheng3, ZHU Jing1. Evaluation of left ventricular function in uremic patients undergoing long-term peritoneal dialysis by myocardium layerspecific strain and myocardial work. Journal of Jiangsu University(Medicine Edition), 2023, 33(02): 93-98.
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