Study of right ventricular function with preserved left ejection fraction by three-dimensional speckle tracking in uremic patients undergoing peritoneal dialysis

This study aimed to test the ability of real-time three-dimensional echocardiography (RT3DE) to characterize early abnormalities of right ventricular (RV) structure and function with preserved left ventricular (LV) ejection fraction (EF) in uremic patients undergoing peritoneal dialysis (PD). Sixty-six uremic patients with preserved left ventricular ejection fraction (> 50% LVEF) undergoing peritoneal dialysis and 20 healthy control participants underwent both standard and RT3DE assessment. The PD patients with right ventricular ejection fraction (RVEF) > 45% composed group A (45 patients), and all other patients were included in group B (21 patients). The RV volume and ejection fraction, global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) were calculated using RT3DE. GLS in Group A was significantly lower than the GLS in the control group. In patients with abnormal right ventricular function, GCS, GAS, GRS and GLS were lower in the group B than in healthy controls. Compared with the control subjects, GLS, GRS, and GAS were lower among PD patients, but the GCS was similar among the groups. The right ventricular GLS of patients undergoing peritoneal dialysis decreased prior to the decline in before the right ventricular ejection function became worse. GLS is a sensitive index marker for assessing right ventricular function in patients with peritoneal dialysis. In uremic patients undergoing peritoneal dialysis with obvious abnormal right ventricular systolic function, GLS, GRS, GAS, and GCS were all decreased.