Patients with end-stage renal disease (ESRD) more frequently develop a wide range of left ventricular (LV) structural and functional abnormalities.

The aim of our study is to evaluate the left ventricular function using two-dimensional and three-dimensional speckle tracking echocardiography (STE) in ESRD patients with preserved left ventricular ejection fraction (PLVEF) undergoing haemodialysis (HD) treatment.

Thirty patients on maintenance HD were examined before and after HD. All of the patients had normal left ventricular ejection fraction (50% or greater). Using the 2D-STE and 3D-STE methods, values belonging to the LV global longitudinal (GLS), circumferential (GCS) and radial (GRS) peak systolic strain were measured. BNP levels were measured before and after HD.

While the LVEF values in the ESRD group were found to be lower in 3D measurement than in 2D- echocardiography (58.46±7.14 vs. 61.36±7.87, P=0.03). LV global longitudinal and radial peak systolic strain was decreased in the study group population. No difference was observed in terms of the GCS. Strain values improved in longitudinal and radial directions after HD [pre- vs. post-HD; GLS: –16.43 (1.7) vs. –18.49 (1.9)%, p<0.001, GRS: 23.94 (9.2) vs. 30.41 (10.4)%, p<0.001, GCS: -20.23 (3.4) vs. –21.46 (4.9)%, p=0.1]. The GCS was observed as an independent predictor related to the LVEF (beta=0.2, 95% CI: 0.126-0.207, P=0.015). Serum BNP levels were inversely correlated with pre-HD and post-HD GLS (r=–0.673 and r=–0.713 respectively, p<0.01).

In patients with ESRD, although the longitudinal and radial systolic functions are reduced, the LVEF may remain within normal limits due to the preservation of the circumferential functions. 2D-STE has the potential to detect the severity of uraemic cardiomyopathy in the early stages of the disease and might provide useful information for the risk stratification in ESRD patients with PLVEF.