Department of Ultrasound Medicine, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui, China.
Echocardiography. 2024 Oct;41(10):e15941. doi: 10.1111/echo.15941.
Patients with chronic kidney disease (CKD) possess a pronounced risk for cardiovascular events. A noninvasive left ventricular pressure-strain loop (LV-PSL) has recently been introduced to detect subtler changes in cardiac function. This study aims to investigate the value of LV-PSL for quantitative assessment of myocardial work (MW) in patients with CKD.
Seventy-five patients with CKD were enrolled retrospectively (37 patients with CKD Stages 2-3, and 38 patients with CKD Stages 4-5), and 35 healthy volunteers were included as controls. All subjects underwent transthoracic echocardiography. LV-PSL analysis was performed to estimate LV MW and efficiency. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were obtained by echocardiography, and the differences among the groups were compared.
There was a significant increase in GWW and reduction in GWE in patients with CKD compared to normal controls (p < 0.05). No significant difference in GWI and GCW was observed among the three groups. Multiple linear regression revealed that increased GWW was significantly associated with age, serum creatinine, and systolic pressure, and decreased GWE was associated with age, serum creatinine, and GLS.
LV-PSL can be used for noninvasive quantitative assessment of MW in patients with CKD, providing a new sensitive approach for the clinical assessment of myocardial function.
慢性肾脏病（CKD）患者存在明显的心血管事件风险。最近引入了一种无创的左心室压力-应变环（LV-PSL）来检测心脏功能的更细微变化。本研究旨在探讨 LV-PSL 对 CKD 患者心肌做功（MW）定量评估的价值。
回顾性纳入 75 例 CKD 患者（CKD 2-3 期 37 例，CKD 4-5 期 38 例），并纳入 35 名健康志愿者作为对照。所有受试者均接受经胸超声心动图检查。进行 LV-PSL 分析以估计 LV MW 和效率。通过超声心动图获得整体做功指数（GWI）、整体构建功（GCW）、整体无效功（GWW）和整体工作效率（GWE），并比较各组之间的差异。
与正常对照组相比，CKD 患者的 GWW 显著增加，GWE 显著降低（p<0.05）。三组间 GWI 和 GCW 无显著差异。多元线性回归显示，GWW 的增加与年龄、血清肌酐和收缩压显著相关，GWE 的降低与年龄、血清肌酐和 GLS 相关。
LV-PSL 可用于 CKD 患者的 MW 无创定量评估，为心肌功能的临床评估提供了一种新的敏感方法。
