Left Ventricular Systolic Function in Patients with Chronic Renal Insufficiency Using Three-dimensional Speckle Tracking Imaging / 中国医学影像学杂志

ABSTRACT

Purpose To evaluate changes of left ventricular systolic function in patients with different-stage chronic renal insufficiency using three-dimensional speckle tracking imaging (3D-STI).Materials and Methods Twenty-six patients with mild chronic renal insufficiency (CKD2-3 group),20 patients with moderate-severe chronic renal insufficiency (CKD4-5 group),who accepted treatment in the West Coast Medical Center,Qingdao University Affiliated Hospital from June 2015 to June 2016,and 20 healthy volunteers (control group) were enrolled.Routine two-dimensional echocardiography was carried out,and the indicators were compared,including inter-ventricular septum end-diastolic thickness (IVSTd) and left ventricular posterior wall end-diastolic thickness (LVPWTd).In addition,3D-STI analysis was conducted,and the indicators were compared,including left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),three-dimensional left ventricular ejection fraction (3D-LVEF),left ventricular global longitudinal strain (GLS),global radial strain (GRS) and global circumferential strain (GCS).The efficacy of GLS,GCS and GRS in the diagnosis of left ventricular systolic dysfunction in patients with chronic renal insufficiency was compared by ROC curve analysis.Results Compared with the control group,serum creatinine and triglyceride increased (t=22.152 and 2.655),glomerular filtration rate (GFR) and hemoglobin content decreased (t=-36.527 and-19.610),IVSTd increased (t=6.035),and 3D-LVEF,GLS,GRS and GCS decreased (t=-2.958,-5.336,-9.552 and-4.384) in CKD2-3 group.Compared with the control group,systolic blood pressure,serum creatinine,total cholesterol and triglyceride increased (t=15.060,29.461,8.210 and 6.512),GFR and hemoglobin content decreased (t=-67.557 and-28.071),IVSTd increased (t=10.959),and 3D-LVEF,GLS,GRS and GCS decreased (t=-7.315,-7.460,-17.99 and-6.052) in CKD4-5 group.Compared with CKD2-3 group,systolic blood pressure,serum creatinine and total cholesterol increased (t=14.551,28.902 and 8.555),GFR and hemoglobin content decreased (t=-18.455 and-16.832),IVSTd increased (t=7.331),and 3D-LVEF,GRS,GCS and GLS decreased (t=-4.977,-3.847,-4.929 and-2.553) in CKD4-5 group.All the above differences were statistically significant (P＜0.05).ROC curve showed that determining left ventricular systolic dysfunction in patients with chronic renal insufficiency using GLS,GCS and GRS,when the cutoff value of GLS was 17.80％,the sensitivity was the highest (88.89％),and the Youden index was 0.673;however,when the cutoff value of GCS was 14.70％,the specificity was the highest (89.47％),and the Youden index was 0.561.Conclusion In patients with chronic renal insufficiency,left ventricular systolic function reduces,and with the progress of the disease,the cardiac function also gradually reduces.3D-STI can accurately assess changes of left ventricular systolic function in patients with different-stage chronic renal insufficiency.