Evaluation of a single hemodialysis on right ventricular function in patients by 3-dimensional speckle tracking imaging / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the change of right ventricular function before and after single hemodialysis by 3-dimensional speckle tracking imaging( 3D-STI) . Methods Seventy-six patients with end-stage renal disease ( ESRD ) and 35 controls were included .ESRD patients were divided into normal left ventricular ejection fraction group( LVEF ≥ 50％ ,46 cases ,group A ) and decreased LVEF group( LVEF <50％ ,30 cases ,group B) .Conventional echocardiography and 3D-STI parameters including right ventricular end diastolic volume( RVEDV ) ,right ventricular end systolic volume ( RVESV ) ,right ventricular ejection fraction( RVEF) ,right ventricular septal longitudinal strain [ RVLS ( Septum ) ] ,right ventricular free wall longitudinal strain [ RVLS( Freewall ) ] ,basal segment of right ventricular diameter[ RVDd( base ) ] ,right ventricular middle diameter [ RVDd ( mid ) ] ,right ventricular long diameter ( RVLD ) and the upper and lower right ventricular fractional area change ( FAC) were performed in patients and controls before and after a single hemodialysis . Results ① RVEDV ,RVESV ,RVDd( base) ,RVDd( mid) ,RVLD before a single hemodialysis in group A and B were significantly higher than those in control group ( all P < 0 .05) . RVEF , RVLS Freewall ,RVLS( Septum) and FAC in group A and B were significantly lower than those in control group ( all P < 0 .05) . ② RVEDV ,RVESV ,RVEF ,RVLD ,RVLS ( Freewall) were significantly lower in group A after a single hemodialysis ( all P < 0 .05 ) ;RVEDV ,RVESV ,RVEF ,RVLS ( Freewall) ,RVLS ( Septum) were significantly lower in group B after a single hemodialysis( all P < 0 .05) ;RVEDV ,RVESV , RVEF ,RVLS( Septum) and RVLS( Freewall) in group B before a single hemodialysis were lower than those in group A ( all P < 0 .05) . The difference of RVLS Septum decrease in group B after a single hemodialysis was higher than that in group A( P < 0 .05) ;The linear correlations analysis showed that the difference of body weight before and after a single hemodialysis was negatively related with the difference of RVLS ( Freewall) before and after a single hemodialysis( group A r = 0 .351 , P = 0 .017 ;group B r = 0 .696 ,P =0 .000) . Conclusions A single hemodialysis may have injurious effects on right ventricular systolic function and reduce strain value ,which is more significant in group B( LVEF < 50％ ) . Cardiac dysfunction of patients may be remitted by reasonable control of water intake .