Evaluation of early left ventricular systolic function in uremia patients on dialysis by automated cardiac motion quantification

doi:10.3877/cma.j.issn.1672-6448.2021.01.012

Abstract

Abstract:

Objective

To explore the value of automated cardiac motion quantification (aCMQ) in evaluating left ventricular systolic function in uremia patients with different durations of dialysis.

Methods

Fifty-two cases of uremia were selected at First People's Hospital of Xiaoshan District from May 2018 to February 2019. They were divided into three groups according to the duration of hemodialysis. Group A consisted of 27 patients receiving dialysis for ≤ 3 years, group B consisted of 16 patients receiving dialysis for ＞ 3 years to less than 7 years, and group C consisted of 9 patients receiving dialysis for ＞ 7 years. A normal control group consisting of 60 subjects with no past history of heart and kidney disease was also included. M echocardiography was performed to estimate the left ventricular ejection fraction (LVEF) using the Teichholz method, and the X-Plane technique was used to collect four- and two-chamber view images of the heart for four cardiac cycles. Left ventricular end-diastole and left ventricular end-systole were recorded according to electrocardiogram, and the LVEF of the case group and control group was calculated by double plane Simpson method. The aCMQ was used to obtain left ventricular global longitudinal strain (LVGLS). Longitudinal strain of the left ventricle in apical four-chamber view, two-chamber view, and three-chamber view (LVAP4LS, LVAP2LS, and LVAP3LS) was obtained by aCMQ to analyze the changes of left ventricular long axis strain in uremia patients with different durations of dialysis. Analysis of variance was used for comparison among groups, and LSD-t test was used for pairwise comparison between groups.

Results

The mean LVEF measured by the Teichholz method was (67.21±6.63)% in group A, (64.73±6.47)% in group B, (64.58±8.38)% in group C, and (67.02±3.62)% in control group. The mean LVEF measured by Simpson method was (64.71±4.93)% in group A, (64.08±6.02)% in group B, (63.91±7.49)% in group C, and (66.17±3.14)% in control group. There was no significant difference in LVEF between the case groups or between the case group and control group (P＞0.05 for all). The mean values of LVGLS measured by aCMQ were (-20.79±2.70)%, (-20.03±3.58)%, (-18.32±3.71)%, and (-24.39±2.05)% in groups A, B, C, and control group, respectively. The mean values of LVAP4LS during the systolic period were as follows: group A (-22.09±2.76)%, group B (-20.11±3.94)%, group C (-19.49±3.73)%, and control group (-24.61±2.37)%. The mean values of LVAP3LS during the systolic period were as follows: group A (-19.32±3.85)%, group B (-19.28±4.37)%, group C (-16.61±4.40)%, and control group (-23.53±6.18)%. The mean values of LVAP2LS during the systolic period were as follows: group A (-20.09±2.53)%, group B (-19.57±2.65)%, group C (-18.09±4.01%), and control group (-23.51±7.52)%. LVGLS, LVAP4LS, LVAP2LS, and LVAP3LS were significantly reduced in the case groups compared to the control group (group A vs control group: t=-5.949, -3.844, -6.117, and -4.863, P＜0.001 for all; group B vs control group: t=-5.883, -5.619, -5.036, and -4.650, P＜0.001 for all; group C vs control group: t=-6.541, -5.081, -6.130, and -4.854, P＜0.001 for all). The LVGLS, LVAP4LS, and LVAP3LS values of group A were significantly lower than those of group C (t=-2.493, -2.405, and -2.012; P=0.014, 0.018, and 0.047, respectively). The LVAP2LS value did not differ significantly between group A and group B or group C (P＞0.05), and between group B and group C (P＞0.05).

Conclusion

aCMQ can evaluate the abnormality of left ventricular systolic function in uremia patients with different durations of dialysis, which provides a new way for early prevention and treatment of heart failure.

Key words: Echocardiography, Automated cardiac motion quantification, Uremia, Ventricular function

Bin Chen, Lijun Shen, Bowen Zhao, Ran Chen, Jiajia Lu, Shengfang Zhang. Evaluation of early left ventricular systolic function in uremia patients on dialysis by automated cardiac motion quantification[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(01): 56-61.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2021.01.012

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Figures/Tables 4

References 18

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组别		例数	男/女（例）	体质量指数（kg/m²）	LVIDd（mm）	IVSd（mm）		LVEF-Teichholz法（%）		LVEF-Simpson法（%）	Tei指数
A组		27	15/12	21.87±3.12	49.11±6.42^a	11.82±1.71^a		67.21±6.63		64.71±4.93	0.69±0.40^a
B组		16	11/5	22.02±3.79	49.39±3.83^a	12.17±1.54^a		64.73±6.47		64.08±6.02	0.67±0.29^a
C组		9	6/3	21.48±2.91	49.78±5.41^a	12.63±2.34^a		64.58±8.38		63.91±7.49	0.63±0.27^a
对照组		60	37/23	23.22±2.43	46.52±3.61	9.41±1.21		67.02±3.62		66.17±3.14	0.45±0.09
F值			1.458	1.706	3.493	29.646		0.962		1.436	8.030
P值			0.231	0.171	0.018	＜0.001		0.413		0.236	＜0.001
组别	例数		E峰（cm/s）	A峰（cm/s）	E/A		e峰（cm/s）		a峰（cm/s）	s峰（cm/s）	E/e
A组	27		82.41±26.22	96.54±20.47^a	0.87±0.31^ab		5.89±1.36^ab		9.90±1.62^a	7.55±1.27^a	14.21±4.17^a
B组	16		70.63±17.31	85.42±20.21^a	0.86±0.22^ab		5.90±1.11^ab		9.16±1.20	7.17±0.93^a	13.14±3.32^a
C组	9		63.68±19.02^a	97.88±19.53^a	0.64±0.17^a		4.47±1.62^a		9.34±2.12	7.10±1.87^a	15.47±4.94^a
对照组	60		80.09±16.62	61.21±13.82	1.37±0.44		9.61±1.92		8.84±1.52	8.38±1.21	8.38±1.39
F值			3.037	34.634	20.869		52.323		2.918	6.665	34.840
P值			0.032	＜0.001	＜0.001		＜0.001		0.037	＜0.001	＜0.001

组别		例数	男/女（例）	体质量指数（kg/m²）	LVIDd（mm）	IVSd（mm）		LVEF-Teichholz法（%）		LVEF-Simpson法（%）	Tei指数
A组		27	15/12	21.87±3.12	49.11±6.42^a	11.82±1.71^a		67.21±6.63		64.71±4.93	0.69±0.40^a
B组		16	11/5	22.02±3.79	49.39±3.83^a	12.17±1.54^a		64.73±6.47		64.08±6.02	0.67±0.29^a
C组		9	6/3	21.48±2.91	49.78±5.41^a	12.63±2.34^a		64.58±8.38		63.91±7.49	0.63±0.27^a
对照组		60	37/23	23.22±2.43	46.52±3.61	9.41±1.21		67.02±3.62		66.17±3.14	0.45±0.09
F值			1.458	1.706	3.493	29.646		0.962		1.436	8.030
P值			0.231	0.171	0.018	＜0.001		0.413		0.236	＜0.001
组别	例数		E峰（cm/s）	A峰（cm/s）	E/A		e峰（cm/s）		a峰（cm/s）	s峰（cm/s）	E/e
A组	27		82.41±26.22	96.54±20.47^a	0.87±0.31^ab		5.89±1.36^ab		9.90±1.62^a	7.55±1.27^a	14.21±4.17^a
B组	16		70.63±17.31	85.42±20.21^a	0.86±0.22^ab		5.90±1.11^ab		9.16±1.20	7.17±0.93^a	13.14±3.32^a
C组	9		63.68±19.02^a	97.88±19.53^a	0.64±0.17^a		4.47±1.62^a		9.34±2.12	7.10±1.87^a	15.47±4.94^a
对照组	60		80.09±16.62	61.21±13.82	1.37±0.44		9.61±1.92		8.84±1.52	8.38±1.21	8.38±1.39
F值			3.037	34.634	20.869		52.323		2.918	6.665	34.840
P值			0.032	＜0.001	＜0.001		＜0.001		0.037	＜0.001	＜0.001

组别	例数	LVGLS	LVAP4LS	LVAP3LS	LVAP2LS
A组	27	-20.79±2.70^ab	-22.09±2.76^ab	-19.32±3.85^ab	-20.09±2.53^a
B组	16	-20.03±3.58^a	-20.11±3.94^a	-19.28±4.37^a	-19.57±2.65^a
C组	9	-18.32±3.71^a	-19.49±3.73^a	-16.61±4.40^a	-18.09±4.01^a
对照组	60	-24.39±2.05	-24.61±2.37	-23.53±6.18	-23.51±7.52
F值		24.442	15.878	6.813	3.869
P值		＜0.001	＜0.001	＜0.001	0.011

组别	例数	LVGLS	LVAP4LS	LVAP3LS	LVAP2LS
A组	27	-20.79±2.70^ab	-22.09±2.76^ab	-19.32±3.85^ab	-20.09±2.53^a
B组	16	-20.03±3.58^a	-20.11±3.94^a	-19.28±4.37^a	-19.57±2.65^a
C组	9	-18.32±3.71^a	-19.49±3.73^a	-16.61±4.40^a	-18.09±4.01^a
对照组	60	-24.39±2.05	-24.61±2.37	-23.53±6.18	-23.51±7.52
F值		24.442	15.878	6.813	3.869
P值		＜0.001	＜0.001	＜0.001	0.011

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