Quantitative assessment of left ventricular function by left ventricular pressure-strain loop in patients with end-stage renal disease.

Introduction: A new and non-invasive 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 LV structure and MW in patients with end-stage renal disease (ESRD). Methods： 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. Results：The most prevalent anomaly in ESRD patients was left ventricular (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). Conclusions：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.