Evaluation of global and segmental systolic functions of right ventricle in end-stage renal failure patients by real-time three-dimensional echocardiography

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Objective To evaluate the global and segmental (inflow,body and outflow) systolic functions of right ventricle in end-stage renal failure (ESRF) patients by real-time three-dimensional echocardiography(RT-3DE) and four-dimensional right ventricle quantitative analysis (4D-RVQ) and to reveal the long-term impact of renal insufficiency on right ventricular systolic function.Methods RT-3DE was performed in 48 ESRF patients and 26 healthy individuals (control group).Images were acquired and analysed off-line in TomTec 4D-RVQ station.The parameters of RV global and segmental systolic functions,including RV global and segmental end-diastolic volume (EDV),end-systolic volume(ESV),stroke volume(SV),ejection fraction(EF),the time to minimum systolic volume(T-msv) were obtained.All the variables were standardized by body surface area (BSA) or heart rate (HR).Results ① In the ESRF group,EDV,SV and EF of body compartment were significantly higher than those of the controls[EDV:(8.5±3.4)ml/m2 vs (6.4± 1.7)ml/m2,P =0.002;SV:(4.5 ± 1.7)ml/m2 vs (2.7±0.9)ml/m2,P =0.0037;EF:(45.4 ± 11.5)％ vs (41.1 ± 7.1)％,P =0.0489],and so were EDV,SV of inflow compartment [EDV:(19.6± 1.0)ml/m2 vs (16.5±0.9)ml/m2,P =0.0438;SV:(12.3±4.6)ml/m2 vs (10.1±3.2) ml/m2,P =0.0433].②Compared with the control group,the global and segmental T-msv were all delayed obviously in the ESRF group (P ＜ 0.001).③The percentage of SV of body compartment accounting for the global SV significantly increased in the ESRF group [(19.5 ± 7.3)％ vs (15.5 ± 5.5)％,P =0.0222],while that of outflow compartment reduced significantly [(20.3 ± 7.0)％ vs (26.8 ± 8.2)％,P =0.0005].Conclusions The global and segmental systolic functions of right ventricle were impaired in ESRF patients,especially in the body compartment.The RT-3DE and 4D-RVQ are helpful technologies in the evaluation and follow-up of right ventricular systolic function in patients with renal failure. Key words: Echocardiography, real-time three-dimensional; Renal insufficiency; Ventricular function,right