Chen Meihua, Li Bing, Lin Jue, Xing Guanli, Huang Xuning
Department of Ultrasound Medicine, The Second Affiliated Hospital of Hainan Medical University, Haikou, China,
Department of Ultrasound Medicine, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.
Cardiology. 2025 Jan 8:1-13. doi: 10.1159/000543422.
A new and noninvasive technology of left ventricular pressure-strain loop (LV-PSL) has recently been used to provide information on myocardial work (MW) and identify subtle modifications in cardiac function. This study aimed to use LV-PSL for early identification of changes in left ventricular (LV) structure and MW in patients with end-stage renal disease (ESRD).
Seventy-two patients with ESRD were divided into two groups based on undergoing maintenance hemodialysis (MHD), namely, the dialysis group (ESRD-D group) and non-dialysis group (ESRD-ND group). Thirty age- and sex-matched control participants were enrolled in the N group. Traditional echocardiography and LV-PSL measurements were conducted. The values of global longitudinal strain (GLS), peak strain dispersion (PSD), global constructive work (GCW), global wasted work (GWW), global work index (GWI), and global work efficiency (GWE) were assessed.
The most prevalent anomaly in ESRD patients was LV hypertrophy. The GLS value was significantly lower, and PSD was higher in patients with ESRD than in controls. Furthermore, patients with ESRD had severely higher GWW values and lower GWE than the N group (p < 0.05). No significant differences were found in GWI and GCW between the three groups (p > 0.05). Correlation analysis showed that GCW, GWI, and GWE were positively correlated with LV ejection fraction (EF) and negatively correlated with GLS. GWW was negatively correlated with LVEF and positively correlated with GLS and PSD. In addition, GWE was negatively correlated with PSD (all p < 0.05).
Patients with ESRD have LV structural and functional abnormalities. LV-PSL measurement can be helpful in identifying these subclinical abnormalities. MHD did not change myocardial workload in patients with ESRD.
一种新的无创性左心室压力-应变环（LV-PSL）技术最近已被用于提供心肌做功（MW）的信息，并识别心脏功能的细微变化。本研究旨在使用LV-PSL早期识别终末期肾病（ESRD）患者左心室（LV）结构和MW的变化。
72例ESRD患者根据是否接受维持性血液透析（MHD）分为两组，即透析组（ESRD-D组）和非透析组（ESRD-ND组）。30名年龄和性别匹配的对照参与者纳入N组。进行传统超声心动图和LV-PSL测量。评估整体纵向应变（GLS）、峰值应变离散度（PSD）、整体建设性做功（GCW）、整体无用功（GWW）、整体做功指数（GWI）和整体做功效率（GWE）的值。
ESRD患者中最常见的异常是左心室肥厚。ESRD患者的GLS值显著低于对照组，PSD值高于对照组。此外，ESRD患者的GWW值显著高于N组，GWE低于N组（p<0.05）。三组之间GWI和GCW无显著差异（p>0.05）。相关性分析表明，GCW、GWI和GWE与左心室射血分数（EF）呈正相关，与GLS呈负相关。GWW与LVEF呈负相关，与GLS和PSD呈正相关。此外，GWE与PSD呈负相关（均p<0.05）。
ESRD患者存在左心室结构和功能异常。LV-PSL测量有助于识别这些亚临床异常。MHD并未改变ESRD患者的心肌工作量。
