Zhang Yiran, Wu Lizhou, Liang Liming, Li Kuan, Kong Xianglei, Wang Haiyan
Department of Medical Ultrasound, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.
Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University & Shandong provincial Qianfoshan Hospital, Shandong institute of Nephrology, Jinan, Shandong, China.
PLoS One. 2025 Aug 22;20(8):e0324951. doi: 10.1371/journal.pone.0324951. eCollection 2025.
Left ventricular dysfunction (LVD) frequently occurs in patients with chronic renal failure (CRF) who have an arteriovenous fistula (AVF). In a rat model of CRF with AVF, we assessed the utility of transthoracic echocardiography for the early detection of LVD and examined the associated pathological damage.
Forty female rats that had successfully established a CRF model were divided into three groups: the CRF group (n = 13), the sham group (n = 13), and the AVF group (n = 14). The AVF was established (labeled as T0). Renal function and myocardial enzyme parameters were measured at T0, the 4th week (labeled as T1), and the 6th week (labeled as T2). The parameters of echocardiography were measured with an animal ultrasound device (Vevo 3100). The early diastolic peak flow velocity (E) was divided by the mitral valve's E wave deceleration time (DT), to calculate the E/DT ratio. TOMTEC image analysis software was utilized to analyze the LV's global longitudinal strain (GLS) and global circumferential strain (GCS). At each time point, three rats from each group were euthanized, and the left ventricular pathological tissues were collected for HE and Masson staining.
(1) At T1, the AVF group had no significant difference in GLS, although GCS and the E/DT ratio increased. At T2, the AVF showed lower GLS and GCS and a higher E/DT ratio. (2) Significant alterations were observed in AVF group tissues stained with HE and Masson at T1 and T2.
This study found that pathological damage to the left ventricular myocardium persisted after the rat model was established. Unlike traditional echocardiography measurements, GLS, GCS, and the E/DT ratio can detect dynamic changes in left ventricular function.
左心室功能障碍(LVD)常见于患有动静脉内瘘(AVF)的慢性肾衰竭(CRF)患者。在建立了CRF合并AVF的大鼠模型中,我们评估了经胸超声心动图在早期检测LVD中的效用,并检查了相关的病理损伤。
40只成功建立CRF模型的雌性大鼠分为三组:CRF组(n = 13)、假手术组(n = 13)和AVF组(n = 14)。建立AVF(标记为T0)。在T0、第4周(标记为T1)和第6周(标记为T2)测量肾功能和心肌酶参数。用动物超声设备(Vevo 3100)测量超声心动图参数。舒张早期峰值流速(E)除以二尖瓣E波减速时间(DT),计算E/DT比值。利用TOMTEC图像分析软件分析左心室的整体纵向应变(GLS)和整体圆周应变(GCS)。在每个时间点,每组处死3只大鼠,收集左心室病理组织进行HE和Masson染色。
(1)在T1时,AVF组的GLS无显著差异,尽管GCS和E/DT比值增加。在T2时,AVF组的GLS和GCS较低,E/DT比值较高。(2)在T1和T2时,AVF组经HE和Masson染色的组织观察到明显变化。
本研究发现大鼠模型建立后左心室心肌存在持续性病理损伤。与传统超声心动图测量不同,GLS、GCS和E/DT比值可检测左心室功能的动态变化。