Miao Yunxiang, Fan Lin, Zhou Bingyuan, Liao Yuping, Yin Ying
Department of Echocardiography, First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Hemodialysis Center, First Affiliated Hospital of Soochow University, Suzhou, China.
Echocardiography. 2025 Jul;42(7):e70243. doi: 10.1111/echo.70243.
To explore the value of a novel echocardiographic measure-left ventricular pressure-strain loop (LV-PSL) for assessment of patients with chronic kidney disease by comparing the changes before and after hemodialysis (HD).
A total of 117 patients undergoing regular hemodialysis were recruited. Global longitudinal strain (GLS) combined with cuff blood pressure measurement is used to calculate the global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE). The differences in echocardiographic parameters before and after hemodialysis on the same day were compared. Additionally, 50 healthy individuals were included as the control group.
Compared with the control group, both the pre-HD and post-HD groups exhibited significantly lower GLS and GWE (pre-HD: p = 0.006 and p = 0.000, respectively; post-HD: p = 0.000 and p = 0.000, respectively). In contrast, the pre-HD group had significantly higher values in PSD, GWI, GCW, and GWW (p = 0.000 for PSD and GWW; p = 0.001 for GWI and GCW). Notably, the post-HD group also had higher values in PSD and GWW compared to the control group (p = 0.000 for both), while no significant differences were observed in GWI and GCW between the post-HD and control groups (p = 0.247 and p = 0.134, respectively).
The LV-PSL parameters are capable of effectively assessing myocardial work in HD patients. Moreover, these parameters offer novel reference indicators for evaluating volume load and left ventricular myocardial function in HD patients.
通过比较血液透析（HD）前后的变化，探讨一种新型超声心动图测量方法——左心室压力 - 应变环（LV - PSL）在评估慢性肾脏病患者中的价值。
共招募了117例接受规律血液透析的患者。采用整体纵向应变（GLS）结合袖带血压测量来计算整体做功指数（GWI）、整体建设性做功（GCW）、整体无用功（GWW）和整体做功效率（GWE）。比较同一天血液透析前后超声心动图参数的差异。此外，纳入50名健康个体作为对照组。
与对照组相比，HD前组和HD后组的GLS和GWE均显著降低（HD前：p分别为0.006和0.000；HD后：p分别为0.000和0.000）。相比之下，HD前组的PSD、GWI、GCW和GWW值显著更高（PSD和GWW：p = 0.000；GWI和GCW：p = 0.001）。值得注意的是，HD后组的PSD和GWW值也高于对照组（两者p = 0.000），而HD后组与对照组之间的GWI和GCW无显著差异（p分别为0.247和0.134）。
LV - PSL参数能够有效评估HD患者的心肌做功。此外，这些参数为评估HD患者的容量负荷和左心室心肌功能提供了新的参考指标。
