Assessment of right ventricular function by three-dimensional speckle tracking in uremic patients underwent peritoneal dialysis

Abstract

Objective To assess right ventricular(RV) function in patients with uremia underwent peritoneal dialysis using three-dimensional speckle tracking imaging.Methods 69 uremic patients with normal left ventricular ejection fraction and right ventricular ejection fraction values underwent peritoneal dialysis were divided into two groups according to pulmonary artery systolic pressure (PASP).Group A consisted of 36 patients with PASP≤40 mmHg(1 mmHg =0.133 kPa).Group B contained 33 patients with PASP＞40 mmHg.A healthy control group including 31 subjects was designated group N.RV dynamic three-dimensional model was obtained from the apical four-chamber view,afterwards the images were stored and analyzed on EchoPAC workstation.RV global longitudinal peak systolic strain (GLS),global circumferential peak systolic strain(GCS) and global radial peak systolic strain(GRS) from each group were measured and compared.Results RV GLS were significantly decreased in uremic patients group A and B compared with group N (P ＜0.05).RV GLS were even lower in group B compared with group A(P ＜ 0.05).No significant difference was found in RV GRS,GCS among group A,group B and group N(P ＞ 0.05).Conclusions Even RV systolic function is still at a normal level in patients with uremic peritoneal dialysis,but its longitudinal myocardial deformation capacity has been as early as RV systolic function decline,and early in the radial,circumferential direction of the global deformation capacity.The application of three-dimensional speckle tracking technology can accurately detect subclinical RV dysfunction,providing the basis for early clinical intervention. Key words: Echocardiography; Uremia; Peritoneal dialysis; Ventricular function, right; Speckle tracking imaging