Quantitative assessment of myocardial echographic response in chronic uremia

Statistical analysis can provide objective, quantitative informations on both the tonal behavior and the underlying texture of conventional 2-D echocardiograms. In this respect, the myocardium of chronic uremic patients is of special interest. Its histologic pattern, characterized by interstitial fibrosis, as well as by deposits of different substances (calcium, aluminum, collagen) within the fibers, yields abnormal echoreflectivity, qualitatively described by conventional ultrasonic examinations, and hypertrophy. Thirty-one patients under maintenance hemodialysis treatment underwent 2-D echocardiography at the end of the dialytic procedure. Sixteen patients with systemic hypertension, comparable left ventricle hypertrophy and normal renal function served as control group. After digitization of the images obtained from a 4-chamber apical view, statistical analyses were performed on regions of interest localized within the interventricular septa. Various first order parameters significantly discriminated the two groups (p<0.01), while no remarkable difference was detected in second order parameters. It is concluded that the abnormal echo response could be related to deposits of highly reflective substances within the myocardium