Application of non-invasive left ventricular pressure-strain curve in evaluating left ventricular myocardial work in hemodialysis patients / 中华超声影像学杂志

ABSTRACT

Objective:The evaluate left ventricular myocardial work in maintenance hemodialysis (MHD) patients by non-invasive left ventricular pressure strain curve.Methods:Forty-eight patients undergoing maintenance hemodialysis were selected as the MHD group, and 33 healthy subjects were selected as the control group from Apr to Oct 2019 in Henan Provincial People′s Hospital. The differences of general clinical data, basic parameters of two-dimensional ultrasound including left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), stroke volume (SV), diastolic interventricular septal thickness (IVSd), left ventricular diastolic posterior wall thickness (LVPWd), left ventricular diastolic mass (LVDm), left ventricular systolic mass (LVSm), late diastolic tissue velocity (a′), early diastolic peak velocity/early diastolic tissue velocity (E/e′), A peak and cardiac output (CO), peak strain dispersion (PSD), and global work index (GWI), global work efficiency (GWE), global constructive work (GCW), global wasted work (GWW) and global long-axis strain (GLS) between two groups were compared, and the correlation between myocardial work parameters and conventional cardiac parameters was analyzed.Results:①In terms of comparison, LVDd, LVDs, LVEDV, LVESV, SV, IVSd, LVPWd, LVDm, LVSm, systolic blood pressure (SBP), diastolic blood pressure (DBP), a′, E/e′. A peak and CO of the MHD group were greater than those in the control group (all P<0.05), and e′ of the MHD group was lower ( P<0.05). ②In terms of comparison, PSD and GWW of the MHD group were greater than those of the control group (all P<0.05), while GLS and GWE of the MHD group was lower (all P<0.05). There were no statistically significant differences in GCW and GWI between two groups(all P>0.05). ③GWI was positively correlated with SBP, DBP and left ventricular ejection fraction (LVEF)( r1=0.442, P1=0.030; r2=0.477, P2=0.019; r3=0.431, P3=0.040), and negatively correlated with GLS and LVDs( r1=-0.576, P1=0.003; r2=-0.404, P2=0.050). GWW was positively correlated with GLS and PSD( r1=0.584, P1=0.003; r2=0.564, P2=0.004). GWE was positively correlated with LVEF( r=0.424, P=0.044), and negatively correlated with LVEDV, LVESV, PSD, GLS and LVDm( r1=-0.444, P1=0.034; r2=-0.490, P2=0.018; r3=-0.721, P3<0.001; r4=-0.738, P4<0.001; r5=-0.442, P5=0.035). GCW was positively correlated with LVEF and DBP( r1=0.494, P1=0.017; r2=0431, P2=0.035), and negatively correlated with GLS and LVDs( r1=-0.630, P1=0.001; r2=-0.419, P2=0.042). Conclusions:The non-invasive left ventricular pressure-strain curve combines blood pressure and strain. Compared with the GLS, it can accurately assess left ventricular myocardial work in maintenance hemodialysis patients and predict potential left ventricular function changes in maintenance hemodialysis patients.