Key result
Global work efficiency accurately identified left ventricular systolic dysfunction in maintenance hemodialysis patients with left ventricular hypertrophy, yielding an area under the curve of 0.982.
Why the study?
This study aimed to determine LV systolic function in MHD patients using the MW technique and evaluate its clinical value for quantitative analysis in MHD patients with LVH.
Does the myocardial work technique accurately evaluate left ventricular systolic function in maintenance hemodialysis patients with left ventricular hypertrophy?
Observational (n=103)
No
Does the myocardial work technique accurately evaluate left ventricular systolic function in maintenance hemodialysis patients with left ventricular hypertrophy?
Effect estimate: AUC 0.982
Myocardial work parameters, particularly global work efficiency and global wasted work, provide a sensitive and load-independent method for quantitatively evaluating left ventricular systolic dysfunction in maintenance hemodialysis patients with left ventricular hypertrophy.
May aid LV systolic assessment in hemodialysis patients with LVH; extends myocardial work data but remains hypothesis-generating.
BACKGROUND: This study aimed to determine the left ventricular (LV) systolic function in patients on maintenance hemodialysis (MHD) using the myocardial work (MW) technique and investigate the clinical value of the MW technique for the quantitative analysis of left ventricular (LV) systolic function in MHD patients with left ventricular hypertrophy (LVH). METHODS: A total of 68 MHD patients and 35 controls were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n = 35) and the LVH group (n = 33) according to the LV mass index (LVMI). MW was used to generate the LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), and global wasted work (GWW), global work efficiency (GWE). GLS and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) in the LVH group were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD with LVH patients. RESULTS: The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW in the LVH group. Receiver operating characteristic curve (ROC) analysis revealed that GWE, GWW, GWI, and GCW had appreciable area under the curve (AUC), sensitivity, and specificity for evaluating LV function in LVH patients on MHD. CONCLUSIONS: The MW parameters can quantitatively represent the LV myocardial work in MHD patients. Thus, the technique provides a new method for the quantitative evaluation of LV systolic function in MHD with LVH patients.
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Liu et al. (2021) conducted an observational in End-stage renal disease on maintenance hemodialysis (n=103). Maintenance hemodialysis with left ventricular hypertrophy vs. Healthy controls and maintenance hemodialysis patients without left ventricular hypertrophy was evaluated on Diagnostic efficacy of Global Work Efficiency (GWE) for identifying left ventricular dysfunction (AUC 0.982). Global work efficiency accurately identified left ventricular systolic dysfunction in maintenance hemodialysis patients with left ventricular hypertrophy, yielding an area under the curve of 0.982.
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