Systolic Dysfunction In Patients Research Articles

Predictive Value of High-Sensitivity Troponin T for Systolic Dysfunction and Infarct Size (Six Months) After ST-Elevation Myocardial Infarction

The association of markers of myocardial injury and dysfunction with infarct size (IS) and ejection fraction (EF) are well documented. However, limited data are available on the newer high-sensitivity troponin assays and comparison with morphologic and functional assessment with cardiac magnetic resonance imaging. We aimed to examine the associations of high-sensitivity cardiac Troponin-T (hs-cTnT), creatine kinase MB iso-enzyme (CKMB), and N-terminal pro B-type Natriuretic Peptide (NT-proBNP) to IS and EF at 6 months. Blood samples from 119 ST-segment elevation myocardial infarction patients from the Rapid Endovascular Catheter Core Cooling Combined With Cold Saline solution as an Adjunct to Percutaneous Coronary Intervention for the Treatment of Acute Myocardial Infarction trial were collected at baseline, 6, 24, and 48 hours after admission. Cardiac magnetic resonance was performed at 4 ± 2 days and 6 months. The association of biomarker levels to IS and EF was tested with Pearson's correlation coefficients and linear regression models with bootstrap resampling. The correlation coefficient of biomarker to IS was (CKMB: r = 0.71); (NT-proBNP: r = 0.55); (hs-cTnT: r = 0.80); and for EF (CKMB: r = 0.57); (NT-proBNP: r = 0.48); and (peak hs-cTnT: r = 0.68). IS and EF at 4 ± 2 days had the strongest correlations with IS and EF at 6 months respectively (IS: r = 0.84) and (EF: r = 0.74). Receiver operating characteristic of peak hs-cTnT for predicting EF ≤40% at 6 months was 0.87 compared with 0.75 for early IS. Early EF was a negative predictor of late EF <40%, 1-area under curve = 0.93. In conclusion, high-sensitivity Troponin T is a rapid, cheap, generally available tool for accurate prediction of systolic dysfunction in patients 6 months after first-time ST-segment elevation myocardial infarction.

Echocardiographic and clinical markers of left ventricular ejection fraction and moderate or greater systolic dysfunction in left ventricular noncompaction cardiomyopathy

Left ventricular noncompaction (LVNC) is associated with progressive LV systolic dysfunction and dilated cardiomyopathy. We aimed to investigate the echocardiographic and clinical characteristics associated with LV ejection fraction (LVEF) and moderate or greater systolic dysfunction in patients with LVNC. Our institutional echocardiography database was retrospectively reviewed between 2008 and 2014, and 62 patients with LVNC were identified. Forty-three (69%) had moderate or greater LV systolic dysfunction (LVEF≤40%) and were compared with 19 (31%) patients with preserved or mildly reduced LVEF (>40%). Linear regression analyses were utilized to identify markers associated with LVEF. The mean age was 63±17years and noncompacted-to-compacted ratio was 2.3±0.5, and was larger in patients with LVEF≤40% (2.4 vs 2.1; P=.02). Patients with LVEF≤40% were older, had more congestive heart failure, significant QRS interval prolongation, and greater LV remodeling and worse mean global longitudinal strain (GLS). Multivariate regression analysis revealed increased age (standardized regression coefficient (β)=-0.17; P=.04) and QRS duration (β=-0.13; P=.08), congestive heart failure (β=-0.18; P=.04), and worsened GLS (β=-0.40; P=.001) were independently associated with decreased LVEF in the cohort (overall model fit R2 =0.71; P<.0001). Increased age (β=-0.49; P=.01) and QRS duration (β=-0.50; P=.002), and worsened GLS (β=-0.33; P=.04), were also associated with a lower LVEF in patients with LVEF>40%. The independent markers associated with LVEF and moderate or greater LV systolic dysfunction in patients with LVNC, in particular GLS and QRS duration, may detect high-risk candidates for more aggressive clinical surveillance and medical therapy.

Right ventricular systolic dysfunction in patients with coronary artery disease:&#x0D; gender-related differences

Right ventricular (RV) dysfunction is one of the most significant independent predictors of prognosis in patients with coronary artery disease (CAD) presenting with and without myocardial infarction (MI). However, gender-related differences in RV function of CAD patients are still poorly understood. Aim. To elucidate gender-related differences in echocardiographic parameters of the right chambers of the heart in CAD patients. Material and Methods. 719 patients with coronary artery disease undergoing medical examination in the Federal Budgetary Institution Rehabilitation Center «Topaz» of the RF Social Insurance Fund were included in the study. All patients were assigned to two groups according to the gender: Group 1 - men (n = 432, 61 [55; 67] years), Group 2 - women (n = 287, 62 [56; 67] years). Results. The analysis of the structure and systolic function of the RV showed that RV and right atrium (RA) end-diastolic dimension, diastolic RV wall thickness, and RA area were significantly higher in men than in women (p &lt;0.001). Thus, the prevalence of RV systolic dysfunction (SD) was similar in both groups of patients: 17.6% in men and 15% in women (p = 0.356). The independent predictors of LV SD in both groups were as follows: prior coronary artery bypass grafting (CABG), decreased early mitral flow propagation velocity (p &gt; 0.05). However, reduced left ventricular ejection fraction (LVEF; p &lt;0.001) was found only in men. Conclusion. The prevalence of right ventricular systolic dysfunction in patients with coronary artery disease was similar in both men and women. Men demonstrated lower values of systolic and diastolic LV function. The factors associated with RV systolic dysfunction in both groups were as follows: prior CABG and diastolic LV dysfunction. Reduced LVEF was found only in men. The results of this study can be used to assess gender-related differences in RV dysfunction in CAD patients.

O24-3 - Association between Late Gadolinium Enhancement on CMR and Left Ventricular Longitudinal Systolic Dysfunction in Patients with Nonischemic Dilated Cardiomyopathy

O24-3 - Association between Late Gadolinium Enhancement on CMR and Left Ventricular Longitudinal Systolic Dysfunction in Patients with Nonischemic Dilated Cardiomyopathy

New Insights into Cardiac Involvement in Juvenile Scleroderma: A Three-Dimensional Echocardiographic Assessment Unveils Subclinical Ventricle Dysfunction.

Cardiac manifestations in juvenile scleroderma or systemic sclerosis (JSSc) have poor prognosis, begin in early stages of the disease, and remain clinically asymptomatic. New echocardiography modalities, such as 2D/3D speckle tracking (STE, strain analysis for regional and global ventricular functions), can detect cardiac involvement in early stages. We assessed 21 JSSc patients and 19 controls using 2D/3D STE. The left ventricular end diastolic volume, end systolic volume, and ejection fraction of the patient and control groups were significantly different (99.2±23.8 vs. 52±23.8, 40.6±16.0 vs. 20.2±17.4 and 59.2±7.5 vs. 65.6±5.2, respectively). Global longitudinal strain (GLS) and global circumferential strain (GCS) were lower in the patient group (18.4±4.7 vs. 22.4±3.7, 26.4±5.8 vs. 31.4±3.5), as were the peak systolic strain values of the right ventricular longitudinal strain (RVLS) septum and RVLS free wall (18.1±6.8 vs. 24.8±6.0 and 22.8±5.9 vs. 28.0±6.9, respectively). 3D measurements of RVEDV, RVESV, and RVSV were higher in the patient group (88.2±31.3 vs. 50.8±23.5, 43.1±17.6 vs. 19.0±12.2, and 45.0±16.2 vs. 31.7±12.6). RVLS freewall results were lower in the JSSc patients with interstitial lung fibrosis, arthritis, muscle weakness, weight loss, and anti-scl 70 antibodies than in the JSSc patients without these variables. We found that a GCS of <34.5% could identify patients for left ventricular (LV) dysfunction with a sensitivity of 93.3, specificity of 92.9, while an RVEF of <60.7% could identify patients for left ventricular (RV) dysfunction with a sensitivity of 92.9 and specificity of 21.4%. We highlighted key advantages of 3D STE for the tracking of early systolic dysfunction in patients with JSSc who would benefit from medical intervention for cardiac complications.

P2618Increased plasma ACE2 activity is a marker of subclinical LV systolic dysfunction in patients with aortic stenosis

P2618Increased plasma ACE2 activity is a marker of subclinical LV systolic dysfunction in patients with aortic stenosis

Heterogeneity of systolic dysfunction in patients with severe aortic stenosis and preserved ejection fraction.

Left ventricular (LV) systolic strain has been shown to be an early marker of LV dysfunction in patients with severe aortic stenosis (AS) despite preserved ejection fraction (EF). Echocardiography has provided useful data on regional LV strain patterns, but is not as sensitive as magnetic resonance imaging (MRI). No prior studies have used MRI-based strain analysis to characterize regional three-dimensional strain in patients with severe AS. Twelve patients with severe AS and preserved EF underwent MRI-based multiparametric strain analysis. Circumferential and longitudinal strain values were calculated at individual points throughout the LV and analyzed in 12 discrete regions. Strain values were compared to a database of normal controls. Compared to control patients, circumferential strain in AS patients was significantly reduced at the base (P = 0.002), mid (P = 0.042), and inferior walls (P < 0.001). Longitudinal strain was significantly reduced at the base (P < 0.001), mid (P < 0.001), anterior (P < 0.001), and septal (P < 0.001) walls. Among patients with AS, there was heterogeneity in the location and severity of abnormalities in circumferential and longitudinal strains despite the presence of a preserved EF and lack of prior myocardial infarction. LV systolic strain is significantly impaired in patients with AS and preserved EF compared to healthy volunteers. Abnormalities in circumferential and longitudinal strains were heterogeneously distributed across the LV of patients with AS, allowing us to identify sentinel regions that may reflect the earliest signs of developing LV dysfunction.

Value of the neutrophil-to-lymphocyte ratio in predicting left ventricular recovery in patients with peripartum cardiomyopathy.

The aim of this study was to assess the value of the neutrophil-to-lymphocyte ratio (NLR) in predicting left ventricular (LV) recovery in patients with peripartum cardiomyopathy (PPCM). Patients with PPCM (n= 40), who were admitted to our tertiary reference hospital between 2007 and 2015 were retrospectively analyzed. All patients were followed-up for at least 12months after the diagnosis. All patients had standard echocardiographic examination at baseline and the last follow-up visit. Recovery of LV function was defined as the presence of LV ejection fraction (EF) >45%. Data on blood parameters were also collected at baseline. Univariate and multivariate analysis were used to assess the significant predictive variables for persistent LV systolic dysfunction. Of the patients 21 (52.5%) did not recover LV function at the last follow-up visit (nonrecovery group), while 19 of the patients (47.5%) exhibited LV recovery (recovery group). The LV EF and fractional shortening (FS) were significantly lower in the nonrecovery group. The baseline LV end-diastolic diameter, LV end-systolic diameter (LVESD) and systolic pulmonary arterial pressure were significantly increased in the nonrecovery group. The NLR, C‑reactive protein and troponin levels were significantly higher in the nonrecovery group. In multivariate logistic regression analysis only NLR and LVESD were identified as independent predictors of persistent LV systolic dysfunction in patients with PPCM (p= 0.020 and p= 0.009 respectively). Elevated NLR and increased LVESD were independent prognostic factors in predicting persistent LV dysfunction in patients with PPCM. The NLR might assist in identifying high risk patients with PPCM.

Early Systolic Dysfunction Following Traumatic Brain Injury: A Cohort Study

Prior studies have suggested that traumatic brain injury may affect cardiac function. Our study aims were to determine the frequency, longitudinal course, and admission risk factors for systolic dysfunction in patients with moderate-severe traumatic brain injury. Prospective cohort study. Level 1 trauma center. Transthoracic echocardiogram within 1 day and over the first week after moderate-severe traumatic brain injury; transthoracic echocardiogram within 1 day after mild traumatic brain injury (comparison group). Systolic function was assessed by transthoracic echocardiogram, and systolic dysfunction was defined as fractional shortening less than 25%. Multivariable Poisson regression models examined admission risk factors for systolic dysfunction. Systolic function in 32 patients with isolated moderate-severe traumatic brain injury and 32 patients with isolated mild traumatic brain injury (comparison group) was assessed with transthoracic echocardiogram. Seven (22%) moderate-severe traumatic brain injury and 0 (0%) mild traumatic brain injury patients had systolic dysfunction within the first day after injury (p < 0.01). All patients with early systolic dysfunction recovered in 1 week. Younger age (relative risk, 0.87; 95% CI, 0.79-0.94; for 1 yr increase in age) and lower admission Glasgow Coma Scale score (relative risk, 0.34; 95% CI, 0.20-0.58; for one unit increase in Glasgow Coma Scale) were independently associated with the development of systolic dysfunction among moderate-severe traumatic brain injury patients. Early systolic dysfunction can occur in previously healthy patients with moderate-severe traumatic brain injury, and it is reversible over the first week of hospitalization. Younger age and lower admission Glasgow Coma Scale score are independently associated with the development of systolic dysfunction after moderate-severe traumatic brain injury.

Association Between the Inflammatory Biomarkers and Left Ventricular Systolic Dysfunction in Patients with Exacerbations of Chronic Obstructive Pulmonary Disease.

Background:Cardiovascular diseases are an important cause of morbidity and mortality in chronic obstructive pulmonary disease patients. The increased inflammatory biomarker levels predict exacerbations and are associated with cardiovascular diseases in stable chronic obstructive pulmonary disease patients but their role in the settings of acute chronic obstructive pulmonary disease exacerbations has not been determined.Aims:To analyse the association between inflammatory biomarkers and heart failure and also to determine the predictors of mortality in patients with exacerbations of chronic obstructive pulmonary disease.Study Design:Prospective observational study.Methods:We analysed 194 patients admitted for acute exacerbation of chronic obstructive pulmonary disease at The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia. In all patients, C-reactive protein, fibrinogen, N-terminal of the pro-hormone brain natriuretic peptide and white blood count were measured and transthoracic echocardiography was performed.Results:There were 119 men (61.3%) and the median age was 69 years (interquartile range 62-74). Left ventricular systolic dysfunction (ejection fraction <50%) was present in 47 (24.2%) subjects. Patients with left ventricular systolic dysfunction had higher C-reactive protein levels (median 100 vs. 31 mg/L, p=0.001) and fibrinogen (median 5 vs. 4 g/L, p=<0.001) compared to those with preserved ejection fraction. The overall hospital mortality was 8.2% (16/178). The levels of C-reactive protein, fibrinogen, N-terminal pro-brain natriuretic peptide and ejection fraction predicted hospital mortality in univariate analysis. After adjusting for age, hypoxemia and C-reactive protein, ejection fraction remained significant predictors of hospital mortality (OR 3.89, 95% CI 1.05-15.8).Conclusion:Nearly a quarter of patients with the exacerbation of chronic obstructive pulmonary disease present with left ventricular systolic dysfunction which may be associated with mortality.

English

English

Correction: Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study.

[This corrects the article DOI: 10.1371/journal.pone.0174166.].

The presence of diastolic and systolic dysfunction in patients with impaired relaxation filling pattern

Impaired relaxation filling pattern in the presence of preserved left ventricular ejection fraction is a common finding which is ascribed to early diastolic dysfunction. We thought to determine the distribution of various markers of systolic and diastolic dysfunction in these patients. A total of 106 patients were included in this retrospective observational study. Diastolic dysfunction was defined using the American Society of Echocardiography recommendations ("50% rule"). The systolic dysfunction was evaluated by global longitudinal strain and circumferential strain. For further analysis, the patients were divided into the lower strain (lower tertile) and higher strain (upper tertiles) groups based on longitudinal strain. There were marked differences between the groups in essential echocardiographic parameters. Patients in the lower strain group were more likely to have definite diastolic dysfunction (23% vs 7%, P<.01) and less likely to have normal diastolic function (54% vs 80%, P<.01). They also showed lower circumferential strain (-21.2% vs -25.7%, P<.01). In multivariate analysis, left atrial enlargement (odds ratio (OR) 4.6, 95% confidence interval (CI) 1.2-17.1), left ventricular mass index (OR 1.03, 95% CI 1.0-1.1), left ventricular end-diastolic volume (OR 1.1, 95% CI 1.0-1.1), and E-wave deceleration time (OR 0.99, 95% CI 0.98-1.0) were independently associated with lower global longitudinal strain. Patients with impaired relaxation filling pattern in the presence of preserved left ventricular ejection fraction have a wide spectrum of left ventricular systolic and diastolic performance abnormalities. Isolated assessment of diastolic dysfunction may not fully characterize this group of patients.

Right Ventricular Systolic Dysfunction in Chagas Disease Defined by Speckle-Tracking Echocardiography: A Comparative Study with Cardiac Magnetic Resonance Imaging

Chagas disease leads to biventricular heart failure, usually with prominent systemic congestion. Although echocardiography is widely used in clinical routine, the utility of echocardiographic parameters to detect right ventricular (RV) systolic dysfunction in patients with Chagas disease is unknown. We sought to study the diagnostic value of echocardiography, including speckle-tracking parameters, to distinguish individuals with RV systolic dysfunction from those with normal RV systolic function in Chagas disease using cardiac magnetic resonance (CMR) as the reference method. In this cross-sectional study, 63 individuals with Chagas disease underwent echocardiography and CMR evaluations. Conventional echocardiographic parameters for RV functional evaluation were tricuspid annular plane systolic excursion, RV systolic excursion velocity, fractional area change, and RV index of myocardial performance. Strain and strain rate were obtained by two-dimensional speckle-tracking echocardiography and defined as "RV free wall," when based only in segments from RV free wall, or "RV free wall and septum," when segments from both free RV wall and interventricular septum were included. RV systolic dysfunction was defined as RV ejection fraction (RVEF)<50% by CMR. Mean age was 56±14years, and 58.7% of the patients were men. RV systolic dysfunction was detected by CMR in 18 (28.6%) individuals. RV free wall strain showed the highest correlation with RVEF by CMR (r=-0.62, P<.001), followed by fractional area change (r=0.56, P<.001), RV free wall and septum strain (r=-0.54, P<.001), RV free wall and septum strain rate (r=-0.47, P<.001), RV free wall strain rate (r=-0.45, P<.001), and RV systolic excursion velocity (r=0.30, P=.016). The RV index of myocardial performance and tricuspid annular plane systolic excursion showed a small and not significant correlation with RVEF (r=-0.20, P=.320; r=0.14; P=.289, respectively). Using predefined cutoffs for RV systolic dysfunction, RV free wall strain (>-22.5% for men and >-23.3% for women) exhibited the highest area under the receiver operating characteristic curve (area under the curve=0.829) to differentiate the presence from the absence of RV systolic dysfunction in Chagas disease, with a sensitivity and specificity of 67% and 83%, respectively. RV free wall strain is an appropriate and superior echocardiographic variable for evaluating RV systolic function in Chagas disease, and it should be the method of choice for this purpose.

GLOBAL LONGITUDINAL STRAIN IN PATIENTS WITH NEW LEFT VENTRICULAR SYSTOLIC DYSFUNCTION AFTER ANTICANCER TARGETED THERAPIES

Background: Reductions in global longitudinal strain (GLS) may be observed prior to the onset of systolic dysfunction in patients receiving trastuzumab and anthracycline agents and has been targeted as a method of early detection of cardiotoxicity. Data on cardiotoxicity in the setting of non-

Subclinical left ventricular systolic dysfunction in patients with severe aortic stenosis: A speckle-tracking echocardiography study.

In patients with aortic stenosis (AS), the left ventricular (LV) geometry changes due to the increased LV afterload. However, subclinical myocardial dysfunction can develop despite a normal LV ejection fraction (EF). This study was an investigation of subclinical LV systolic dysfunction in patients with severe AS with a normal LV EF using a strain imaging method, speckle-tracking echocardiography (STE), and an evaluation of its correlation with novel indices to assess the severity of AS. A total of 45 asymptomatic patients with severe AS and 25 age- and sex-matched controls without any cardiac disease and with preserved LV EF (EF ≥60%) were studied. In addition to performing conventional echocardiography and STE-based strain imaging, novel indices (energy loss index [ELI], valvulo-arterial impedance, systemic arterial compliance) were also measured. The LV EF, and the LV end-diastolic and end-systolic diameters were similar in the 2 groups. The LV longitudinal peak systolic strain (10.66±1.15% to 19.66±2.62%; p=0.0001) and strain rate (0.32±0.07 s-1 to 1.85±0.32 s-1; p=0.0001) were significantly impaired in the study patients compared to the controls, demonstrating subclinical ventricular systolic dysfunction. A significant positive correlation was observed between the ELI and the LV strain/strain rate (r=0.45, p=0.002; r=0.55, p=0.0001, respectively). Patients with severe AS develop subclinical LV systolic dysfunction, despite a preserved EF. Novel strain imaging-based echocardiographic techniques may provide additional data that can detect early myocardial systolic deterioration in these patients.

Role of mitral annular plane systolic excursion in prediction of left ventricular subclinical systolic dysfunction in patients with type 2 diabetes: a speckle tracking echocardiography study

Role of mitral annular plane systolic excursion in prediction of left ventricular subclinical systolic dysfunction in patients with type 2 diabetes: a speckle tracking echocardiography study

Increased Plasma ACE2 Activity is a Marker of Subclinical LV Systolic Dysfunction in Patients With Aortic Stenosis

Background: Subclinical left ventricular systolic dysfunction (LVSD) determined by global longitudinal strain (GLS) portends a poor prognosis in patients with aortic stenosis (AS). Angiotensin converting enzyme 2 (ACE2) is a membrane bound protein highly expressed in the human heart and functions to degrade the vasoconstrictor, profibrotic peptide, angiotensin II. Plasma ACE2 levels are elevated in patients with heart failure. In patients with AS, it is not known if early maladaptive processes within the myocardium are associated with changes in plasma and/or tissue ACE2. Aim/Methods: To investigate if subclinical LVSD in patients with AS is associated with elevated plasma ACE2 activity and/or reduced myocardial ACE2 gene expression. Plasma ACE2 activity was measured in 111 patients with AS and normal LV ejection fraction with satisfactory (≤ -15%, n = 77) and abnormal (> -15%, n = 34) GLS. Gene expression of ACE2 was measured in atrial samples collected from a subset of patients during aortic valve replacement (n = 20). Results: Median [25th, 75th quartile] plasma ACE2 activity was significantly higher in patients with abnormal versus normal GLS (29.0 [18.5, 45.25] vs. 20.8 [12.8, 35.04] pmol/ml/min; p = 0.03). Myocardial ACE2 gene expression was significantly reduced (0.5-fold, p = 0.01) in those with abnormal GLS (n = 10) compared to normal GLS (n = 10). Plasma ACE2 activity correlated negatively with ACE2 mRNA (R = - 0.45, p = 0.047). Conclusions: In patients with AS, elevated plasma ACE2 activity is associated with subclinical LVSD and reduced myocardial ACE2 gene expression. Approaches to enhance cardiac ACE2 may have a role in preventing progression to overt LV dysfunction in AS.

Longitudinal ventricular systolic dysfunction in patients with very severe obstructive sleep apnea: A case control study using speckle tracking imaging

ObjectiveObstructive sleep apnea (OSA) is a prevalent condition that is increasingly recognized to be associated with cardiovascular disease. We aimed to investigate the subclinical systolic ventricular dysfunction of patients with OSA using novel speckle tracking echocardiographic (STE) techniques. MethodsThis study included 31 patients of polysomnography proven very severe OSA [Apnea Hypopnea Index(AHI) >40] and an equal number of matched population with no OSA as controls. All the study participants underwent a detailed conventional and tissue Doppler strain echocardiogram in addition to STE. ResultsThere was no significant difference in conventional ventricular systolic function parameters including left ventricular (LV) ejection fraction, and myocardial performance index of left ventricle. Diastolic function was significantly reduced in patients with OSA as compared to controls. There was no difference in global circumferential strain or time to its peak between the two groups. However global longitudinal LV strain (GLS) was significantly reduced in patients with OSA (p<0.01). Similarly time to peak longitudinal strain was prolonged in the OSA group as compared to controls. Segmental analysis revealed that the longitudinal strain abnormalities were more pronounced in the apical and mid segments of LV. AHI remained the only significant predictor of GLS in these patients. ConclusionVery severe OSA is associated with significant diastolic dysfunction as well as early systolic abnormalities as evidenced by abnormal global longitudinal strain. Sleep apnea severity as measured by AHI was the only significant predictor of abnormal longitudinal strain in these patients.

2-D Speckle tracking in the assessment of left and right ventricular functions in hemodialysis versus recently diagnosed uremic patients with preserved systolic function

Several studies have demonstrated that uremic patients who have preserved left ventricular (LV) systolic function could still have subtle systolic dysfunction. In our study, we assessed the right ventricular (RV) and LV myocardial functions measured by conventional echocardiography and two-dimensional (2D) longitudinal speckle-tracking in hemodialysis and non-dialysis recently diagnosed uremic patients. The study population consisted of 24 newly diagnosed uremic patients, 25 hemodialysis patients, and 20 healthy controls. The RV and LV longitudinal strains were significantly lower in patients than in controls (−9.6 vs. −15.3, P<0.001 for RV and −11.3 vs. −14.8, p<0.001 for LV). In the hemodialysis group, the RV longitudinal strain was significantly lower than in the non-dialysis group (p=0.018). The RV longitudinal strain was correlated with hypertension and LV strain. The 2-D longitudinal speckle tracking can detect early ventricular (left and right) systolic dysfunction in patients with uremia in the presence of normal systolic function by conventional methods.