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Updated: Jun 11, 2025
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Assessment of Left Ventricular Functional Impairment in Patients With Chronic Kidney Disease Using Three-Dimensional
Xue Gao1,2, Weiwei Xiao1,3, Liqin Ji1,3
1Institution of Medical Imaging, Guizhou Medical University, Guiyang, Guizhou, China.
Insights
Three-dimensional speckle tracking imaging (3D-STI) effectively detects left ventricular (LV) dysfunction in chronic kidney disease (CKD) patients. Advanced 3D-STI parameters, particularly 3D-LVGLS, correlate with disease severity and predict progression to end-stage renal disease (ESRD).
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Background:
- Chronic kidney disease (CKD) significantly increases cardiovascular disease (CVD) risk, with left ventricular (LV) myocardial damage being a primary concern.
- Early detection of LV dysfunction is crucial for managing CKD patients and preventing adverse cardiovascular outcomes.
- Traditional echocardiography may not fully capture subtle changes in LV function in CKD.
Purpose of the Study:
- To evaluate the utility of three-dimensional speckle tracking imaging (3D-STI) in assessing left ventricular (LV) dysfunction in patients with chronic kidney disease (CKD).
- To compare the diagnostic performance of 3D-STI parameters with conventional two-dimensional speckle tracking echocardiography (2D-STE).
- To identify echocardiographic predictors of CKD progression to end-stage renal disease (ESRD).
Main Methods:
- Echocardiography, including 2D-STE and 3D-STI, was performed on 110 CKD patients and 55 healthy controls.
- CKD patients were stratified into two groups (CKD1 and CKD2) based on estimated glomerular filtration rate (eGFR).
- Correlation and receiver operating characteristic (ROC) curve analyses were used to assess 3D-STI's diagnostic value and identify risk factors for ESRD.
Main Results:
- Patients in the more advanced CKD group (CKD2) exhibited significantly impaired LV systolic function, as indicated by reduced 2D and 3D ejection fraction and strain parameters, compared to controls and the CKD1 group.
- The absolute value of 3D-left ventricular global longitudinal strain (3D-LVGLS) strongly correlated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and serum creatinine (Scr).
- 3D-STI parameters, specifically 3D-LVGLS and 3D-left ventricular global circumferential peak strain (3D-LVGCS), demonstrated superior diagnostic efficacy for LV systolic dysfunction compared to 2D-LVGLS. 3D-LVGLS was independently associated with CKD progression to ESRD.
Conclusions:
- 3D-STI is a valuable tool for detecting and quantifying LV dysfunction in CKD patients.
- 3D-LVGLS is a sensitive marker of LV systolic impairment in CKD, correlating with established biomarkers and predicting disease progression.
- 3D-STI parameters offer enhanced diagnostic capabilities for assessing cardiac involvement in CKD, aiding in risk stratification for ESRD.
Background:
Chronic kidney disease (CKD) is strongly linked to the incidence and mortality of cardiovascular diseases (CVDs), with left ventricular myocardial damage being the most prevalent. This study aimed to assess left ventricle (LV) dysfunction using three-dimensional speckle tracking imaging (3D-STI) in CKD patients.
Methods:
A total of 110 CKD patients and 55 healthy volunteers underwent echocardiography. CKD patients were divided into CKD1 group and CKD2 group based on the estimated glomerular filtration rate (eGFR). Assessing cardiac function via two-dimensional speckle tracking echocardiography (2D-STE) and three-dimensional speckle tracking echocardiography (3D-STE) parameters, with strain presented in absolute terms. Collecting and comparing clinical and echocardiographic parameters from three groups, assessing 3D-STI's value in evaluating LV functional impairment in CKD patients via correlation and receiver operating characteristic (ROC) curve analyses, and identifying risk factors for CKD progression to end-stage renal disease (ESRD) through univariate and multivariate analyses.
Results:
In CKD2 group, 2D-left ventricular ejection fraction (LVEF), 3D-LVEF, 2D left ventricular global longitudinal strain (2D-LVGLS), 3D-LVGLS, and 3D-left ventricular global circumferential peak strain (LVGCS) significantly worsen compared to the control and CKD1 groups, with statistically significant distinctions between the latter two (all p < 0.05). The absolute value of 3D-LVGLS shows a robust correlation with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and serum creatinine (Scr) (r = -0.598, -0.649, both p < 0.001). ROC curve analysis indicates higher diagnostic efficacy of 3D-LVGLS and 3D-LVGCS for LV systolic function than 2D-LVGLS. Univariate and multivariate analyses reveal an independent association of 3D-LVGLS with the progression to ESRD in CKD.
Conclusion:
3D-LVGLS and 3D-LVGCS effectively detect LV dysfunction in CKD patients. Specifically, 3D-LVGLS demonstrates a robust correlation with NT-proBNP and Scr and is independently linked to CKD progressing to ESRD.
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