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

Background: Peak systolic longitudinal strain (PSLS) obtained using the 2D speckle tracking method is a novel indicator of the long-axis function of the left ventricle (LV). We used the 2D strain profile to examine the effect of preload reduction by hemodialysis (HD) on LV PSLS in patients with end-stage renal disease (ESRD). Method and results: Twenty-nine pairs of echocardiographic evaluations were obtained before and after dialysis. Global LV PSLS was -18.4 +/- 2.9%, at baseline and decreased to -16.9 +/- 3.2% after HD (P < 0.001). Segmental analysis showed that the decrease in PSLS after dialysis was most prominent in mid-LV segments (-17.1 +/- 3.5% vs. -15.4 +/- 3.4%, P < 0.001). Conclusion: PSLS obtained from the 2D strain profile is a reliable parameter that may be useful for evaluating LV systolic long-axis function. However, PSLS should be applied cautiously in ESRD patients because it could be affected by dialysis.