Effect of preload on left ventricular longitudinal strain by 2D speckle tracking

Area of Science:

• Cardiology
• Medical Imaging
• Renal Medicine

Background:

• Peak systolic longitudinal strain (PSLS) is a novel echocardiographic parameter assessing left ventricular (LV) long-axis function.
• End-stage renal disease (ESRD) patients often undergo hemodialysis (HD), which alters fluid status and cardiac preload.
• The impact of HD-induced preload reduction on LV PSLS in ESRD patients is not fully understood.

Purpose of the Study:

• To investigate the effect of preload reduction during hemodialysis on LV PSLS in patients with ESRD.
• To evaluate the utility of 2D strain profile for assessing LV systolic function changes post-hemodialysis.

Main Methods:

• Utilized 2D speckle tracking echocardiography to obtain PSLS measurements.
• Collected 29 pairs of echocardiographic evaluations before and after hemodialysis in ESRD patients.
• Performed global and segmental LV PSLS analysis.

Main Results:

• Global LV PSLS decreased significantly after hemodialysis (from -18.4 ± 2.9% to -16.9 ± 3.2%, P < 0.001).
• Segmental analysis revealed the most pronounced PSLS decrease in mid-LV segments (-17.1 ± 3.5% vs. -15.4 ± 3.4%, P < 0.001).

Conclusions:

• PSLS derived from the 2D strain profile is a reliable parameter for LV systolic long-axis function assessment.
• PSLS values in ESRD patients can be significantly affected by hemodialysis-induced preload changes.
• Clinical application of PSLS in ESRD patients requires careful consideration of their fluid status and dialysis treatment.