To analyze the characteristics of changes in left ventricular energy loss(EL) in patients with chronic kidney disease (CKD) with diastolic dysfunction by vector flow mapping (VFM) technique and explore the clinical value of EL in evaluating left ventricular diastolic function in patients with CKD.

Fifty-eight CKD patients were divided into two groups according to diastolic dysfunction:patients with GradeⅠ diastolic dysfunction with normal left atrial pressure (DD1 group) and those with GradeⅡor Ⅲ diastolic dysfunction with increased left atrial pressure (DD2 group). Thirty-eight healthy adults were enrolled as a control group. VFM analysis was executed to calculate the average left ventricular EL during the early filling phase (E-EL-ave), atrial filling phase (A-EL-ave), diastole phase (D-EL-ave), and systolic phase (S-EL-ave). The rate of average EL during early filling and atrial filling is expressed as E/A-EL, and the difference among the three groups were compared.

A-EL-ave and S-EL-ave in the DD1 group were significantly higher than those of the control group (P＜0.01for both).Average energy loss in different phases in the DD2 group were all higher than those in the control group (P＜0.05 for all). E/A-EL had excellent diagnostic efficacy for CKD patients with normal left atrial pressure with a cut-off value of ＜1.27 (area under the curve[AUC]=0.900,P＜0.01); the combination of E/A-EL and E/ e' had excellent diagnostic efficacy for CKD patients with increased left atrial pressure with a cut-off value of 1.28 (AUC=0.945, P＜0.01). E wave,A wave,E/e',LAVImax, and cardiac index were independently correlated with E-EL-ave and A-EL-ave (adjusted R²=0.546, 0.613, P<0.01 for both), respectively.

VFM technology can reflect the impaired left ventricular diastolic function in CKD patients from the perspective of hemodynamics, and the energy loss is related to the indicators for evaluating left ventricular diastolic function.