Assessment of left ventricular diastolic function in patients with uremia by diastolic strain rate parameters

Objective To evaluate the left ventricular diastolic function in patients with uremia by two-dimensional speckle tracking technology (2D-STI). Methods Ninety-three patients with uremia (serum creatinine value≥700 μmol/l) and 29 controls were included. Uremia patients were divided into group with decreased LVEF (LVEF < 50%, group C, 19 cases) and group with normal LVEF (LVEF≥50%). The latter were divided into group with normal diastolic function (group A, 31 cases) and group with diastolic dysfunction (group B, 23 cases) according to the diastolic function; pulsed wave tissue Dopper imaging datas included: diastolic velocity e1′, a1′ and e2′, a2′ at septal or lateral sites of mitral annulus, average E/e′ and e′/a ′. 2D-STI strain and strain rate parameters included: the longitudinal peak systolic strain (GLS), the longitudinal peak systolic strain rate (LSRs), longitudinal peak strain rate in early diastole (LSRe) and E/LSRe. Results ①Systolic function parameters: compared with control group, LVEF decreased significantly only in group C(P 0.05); GLS in group A, B and C decreased significantly and showed a decreasing trend among these three groups(P 0.05). ②Diastolic function parameters: compared with control group, the average E/e′ decreased significantly in group B and C(P 0.05). Compared with group A, the average E/e′ increased significantly in group B and C(P<0.05). Compared with control group, LSRe in three uremia groups decreased significantly, which showed a decreasing trend among these three groups(P<0.05); however, E/LSRe in three uremia groups increased significantly and showed an increasing trend among these three groups(P<0.05). ③The correlation analysis showed that there were positive correlations between average e′ and LSRe and between average E/e′ and E/LSRe in uremic patients. Conclusions In patients with uremia, left ventricular systolic and diastolic function impaired in the early phase. Strain rate parameters in diastole especially E/LSRe obtained by 2D-STI can be used as sensitive, early parameter for evaluation of left ventricular diastolic dysfunction.