Two‐dimensional speckle tracking to image ventricular‐arterial coupling in uremia

OBJECTIVE: To study ventricular‐arterial coupling(VAC) in uremic patients by application of two‐dimensional speckle tracing imaging (2DSTI). METHODS: One hundred uremic patients were divided into two groups based on left ventricular ejection fraction (LVEF): group 1 with LVEF ≥ 5%, and group 2 with LVEF < 55%. Forty healthy subjects were recruited as a control group. Conventional echocardiography was performed; VAC components and myocardial performance index were calculated. Longitudinal strain (LS) of 17 segments was measured using 2DSTI. Mean base (LS(BA)), papillary muscle (LS(PM)), and apex values (LS(AP)) were calculated. RESULTS: Compared to subjects in the control group and group 1, subjects in group 2 exhibited decreased LV end‐diastolic volume (EDV), end‐systolic volume (ESV), LV mass index (LVMI), and VAC (P < 0.05). EF, fractional shortening (FS), end‐systolic elastance (Ees) were significantly higher in group 2 (P < 0.05). SL(BA), SL(PM), and SL(AP) differed significantly among the groups (all P < 0.05). SL(BA), SL(PM), and SL(AP) correlated positively with Ees, EF, and FS (all P < 0.05) but negatively with arterial elastance (Ea), VAC, systemic vascular resistance index (SVRI), and rate‐pressure product (RPP) (all P < 0.05). Multiple regression analysis revealed that relative wall thickness (RWT), LVMI, LS(AP), and stroke works (SW) were independent predictors of VAC (b′ = −0.443, 0.537, −0.470, and −0.491, all P < 0.05). CONCLUSIONS: In patients with uremia, LV myocardial LS gradually decreased as LV systolic dysfunction decreased. VAC correlated negatively with left ventricular LS, and LS(AP) was an independent predictor for VAC.