title: Assessment of myocardial mechanics in patients with end-stage renal disease and renal transplant recipients using speckle tracking echocardiography.
abstract: OBJECTIVE
  Velocity vector imaging allows quantitation of myocardial strain and strain rate from 2-dimensional images based on speckle tracking echocardiography. The aim of this study was to analyze the changes in myocardial strain and strain rate patterns in patients with end-stage renal disease and renal transplant recipients.
  
  
  METHODS
  We studied 33 patients with end-stage renal disease on hemodialysis (19 men; mean age, 36 ± 8 y), 24 renal transplant recipients with functional grafts (21 men; mean age, 36 ± 7 y) and 26 age- and sex-matched control subjects. Longitudinal peak systolic strain and strain rate for basal, mid, and apical segments of the left ventricular wall were determined by velocity vector imaging from apical 4- and 2-chamber views. The average longitudinal strain and strain rate for the left ventricle were noted. From short-axis views at the level of papillary muscles, average circumferential, and radial strain, and strain rate were assessed.
  
  
  RESULTS
  Mean heart rate and systolic and diastolic blood pressure during imaging were similar between the groups. Longitudinal peak systolic strain and strain rate at basal and mid-segments of the lateral wall were significantly higher in renal transplant recipients and control groups than endstage renal disease patients. Average longitudinal systolic strain from the 4-chamber view was highest in control subjects (-14.5% ± 2.9%) and was higher in renal transplant recipients (-12.5% ± 3.0%) than end-stage renal disease patients (-10.2% ± 1.6%; P ≤ .001). Radial and circumferential strain and strain rate at the level of the papillary muscle were lower in patients with end-stage renal disease than other groups.
  
  
  CONCLUSIONS
  Differences in myocardial function in patients with end-stage renal disease, renal transplant recipients, and normal controls can be quantified by strain imaging. Myocardial function is improved in renal transplant recipients compared with end-stage renal disease patients.
authors.affiliation: From the Department of Cardiology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Bahar
authors.initials: B
authors.lastname: Pirat
authors.forename: Huseyin
authors.initials: H
authors.lastname: Bozbas
authors.forename: Vahide
authors.initials: V
authors.lastname: Simsek
authors.forename: L Elif
authors.initials: LE
authors.lastname: Sade
authors.forename: Burak
authors.initials: B
authors.lastname: Sayin
authors.forename: Haldun
authors.initials: H
authors.lastname: Muderrisoglu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D001794:Blood Pressure; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D006339:Heart Rate; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D013314:Stress, Mechanical; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left