{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T18:31:26Z","timestamp":1774031486880,"version":"3.50.1"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013061","name":"Jilin Provincial Scientific and Technological Development Program","doi-asserted-by":"publisher","award":["YDZJ202501ZYTS225"],"award-info":[{"award-number":["YDZJ202501ZYTS225"]}],"id":[{"id":"10.13039\/501100013061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Velocity vector imaging (VVI) stratified strain analysis was used to assess circumferential strain across myocardial layers in uremic patients using a 16-segment left ventricular model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were accessed for research purposes from 1\/5\/2025\u20131\/6\/2025. Sixty hemodialysis patients were divided into left ventricular hypertrophy (LVH, n\u2009=\u200930) and normal LV conformation (LVN, n\u2009=\u200930) groups based on LV mass index, alongside 27 healthy controls (CON). Clinical and echocardiographic data were analyzed, with VVI quantifying systolic circumferential strain (CS) in endocardial (Endo), mid-myocardial (Myo), and epicardial (Epi) layers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The LVH and LVN groups exhibited significant differences compared to the CON group in SBP, Hb, BUN, Scr, eGFR, and hsCRP levels (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Hb levels were uniquely reduced in LVH versus LVN (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Both uremic groups had larger cardiac dimensions (LAD, LVPTW, IVST, LVIDd, LVIDs) than CON (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), but similar LVEF (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u20090.05). Basal and mid-segment global strain were impaired in LVH\/LVN (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05), while apical strain differences were only significant in the Epi layer. LVH showed reduced anteroseptal basal strain (Endo\/Myo\/Epi-2CS) and inferoseptal basal (Endo\/Myo-3CS) and anterolateral mid (Epi-12CS) strain versus LVN. Anteroseptal (Endo\/Myo\/Epi-2CS) and inferoseptal (Endo\/Myo-3CS) strains correlated with Hb levels (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). Anteroseptal basal strains (Endo\/Myo\/Epi-2CS) and their combined values significantly predicted myocardial remodeling (AUC,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). While Epi-3CS and its combined values (Endo\/Myo\/Epi-2CS) did not (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The VVI layered strain technique is a precise and sensitive tool for evaluating LV myocardial motion in uremic patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0336766","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T17:46:35Z","timestamp":1774028795000},"page":"e0336766","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of VVI layered strain technology to analyze changes in left ventricular myocardial motion in patients with uremia"],"prefix":"10.1371","volume":"21","author":[{"given":"Xinyan","family":"Dai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9834-3030","authenticated-orcid":true,"given":"Yihua","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianglan","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hailan","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"pone.0336766.ref001","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/S0140-6736(16)32064-5","article-title":"Chronic Kidney Disease","volume":"389","author":"AC Webster","year":"2017","journal-title":"Lancet"},{"key":"pone.0336766.ref002","article-title":"Chronic Kidney Disease","author":"AL Ammirati","year":"2020","journal-title":"Rev Assoc Med Bras (1992)"},{"issue":"1","key":"pone.0336766.ref003","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-007525","article-title":"Prevalence of chronic kidney disease in Asia: a systematic review and analysis","volume":"7","author":"T Liyanage","year":"2022","journal-title":"BMJ Glob Health"},{"issue":"9888","key":"pone.0336766.ref004","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/S0140-6736(13)60687-X","article-title":"Chronic kidney disease: global dimension and perspectives","volume":"382","author":"V Jha","year":"2013","journal-title":"Lancet"},{"issue":"10225","key":"pone.0336766.ref005","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/S0140-6736(19)32977-0","article-title":"The global burden of chronic kidney disease","volume":"395","author":"P Cockwell","year":"2020","journal-title":"Lancet"},{"key":"pone.0336766.ref006","doi-asserted-by":"crossref","DOI":"10.1053\/j.ajkd.2019.01.001","article-title":"US Renal Data System 2018 Annual Data Report: Epidemiology of Kidney Disease in the United States","volume":"73","author":"R Saran","year":"2019","journal-title":"American Journal of Kidney Diseases: The Official Journal of the National Kidney Foundation"},{"issue":"3","key":"pone.0336766.ref007","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1053\/j.ajkd.2019.02.013","article-title":"Reduced Estimated GFR and Cardiac Remodeling: A Population-Based Autopsy Study","volume":"74","author":"K Izumaru","year":"2019","journal-title":"Am J Kidney Dis"},{"key":"pone.0336766.ref008","doi-asserted-by":"crossref","first-page":"5425","DOI":"10.3390\/ijms24065425","article-title":"miRNAs in Uremic Cardiomyopathy: A Comprehensive Review","volume":"24","author":"M D\u2019Agostino","year":"2023","journal-title":"Int J Mol Sci"},{"key":"pone.0336766.ref009","first-page":"514","article-title":"Kidney measures beyond traditional risk factors for cardiovascular prediction: A collaborative meta-analysis","volume":"3","author":"K Matsushita","year":"2015","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"4","key":"pone.0336766.ref010","doi-asserted-by":"crossref","DOI":"10.1111\/chf.12030","article-title":"Uremic cardiomyopathy: an underdiagnosed disease","volume":"19","author":"E Alhaj","year":"2013","journal-title":"Congest Heart Fail"},{"issue":"10","key":"pone.0336766.ref011","doi-asserted-by":"crossref","first-page":"2504","DOI":"10.1681\/ASN.2014070714","article-title":"Cause of Death in Patients with Reduced Kidney Function","volume":"26","author":"S Thompson","year":"2015","journal-title":"J Am Soc Nephrol"},{"issue":"11","key":"pone.0336766.ref012","doi-asserted-by":"crossref","first-page":"2357","DOI":"10.1016\/j.jcmg.2020.04.021","article-title":"Defining Myocardial Abnormalities Across the Stages of Chronic Kidney Disease: A Cardiac Magnetic Resonance Imaging Study","volume":"13","author":"MK Hayer","year":"2020","journal-title":"JACC Cardiovasc Imaging"},{"issue":"1","key":"pone.0336766.ref013","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/s12882-021-02345-7","article-title":"Predictors of kidney function recovery among incident ESRD patients","volume":"22","author":"M Santos","year":"2021","journal-title":"BMC Nephrol"},{"issue":"3","key":"pone.0336766.ref014","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1111\/j.1751-7133.2011.00214.x","article-title":"Characteristics of a subset of patients with reversible systolic dysfunction in chronic kidney disease","volume":"17","author":"SM Adhyapak","year":"2011","journal-title":"Congest Heart Fail"},{"key":"pone.0336766.ref015","doi-asserted-by":"crossref","first-page":"1179546821998347","DOI":"10.1177\/1179546821998347","article-title":"Uraemic cardiomyopathy: A review of current literature","volume":"15","author":"K Garikapati","year":"2021","journal-title":"Clin Med Insights Cardiol"},{"issue":"8","key":"pone.0336766.ref016","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1111\/echo.13238","article-title":"Study of Regional Left Ventricular Longitudinal Function in Fetuses with Gestational Diabetes Mellitus by Velocity Vector Imaging","volume":"33","author":"X Wang","year":"2016","journal-title":"Echocardiography"},{"key":"pone.0336766.ref017","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S0041-624X(99)00182-1","article-title":"Speckle tracking for multi-dimensional flow estimation","volume":"38","author":"LN Bohs","year":"2000","journal-title":"Ultrasonics"},{"issue":"7","key":"pone.0336766.ref018","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.echo.2015.05.002","article-title":"Recommendations on the Use of Echocardiography in Adult Hypertension: A Report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE)","volume":"28","author":"TH Marwick","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"issue":"2","key":"pone.0336766.ref019","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1159\/000351758","article-title":"Cardiovascular burden associated with uremic toxins in patients with chronic kidney disease","volume":"38","author":"H Moradi","year":"2013","journal-title":"Am J Nephrol"},{"issue":"3","key":"pone.0336766.ref020","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/s41581-018-0101-8","article-title":"Evolving concepts in the pathogenesis of uraemic cardiomyopathy","volume":"15","author":"X Wang","year":"2019","journal-title":"Nat Rev Nephrol"},{"issue":"1","key":"pone.0336766.ref021","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1161\/CIRCULATIONAHA.111.080770","article-title":"Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes","volume":"126","author":"BA Steinberg","year":"2012","journal-title":"Circulation"},{"issue":"1","key":"pone.0336766.ref022","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1159\/000507727","article-title":"Prediction of All-Cause Mortality Using an Echocardiography-Based Risk Score in Hemodialysis Patients","volume":"11","author":"J Zhu","year":"2021","journal-title":"Cardiorenal Med"},{"issue":"1","key":"pone.0336766.ref023","first-page":"6","article-title":"Comparison of vector velocity imaging and three-dimensional speckle tracking echocardiography for assessment of left ventricular longitudinal strain in hypertrophic cardiomyopathy","volume":"2019","author":"HM Badran","year":"2019","journal-title":"Glob Cardiol Sci Pract"},{"issue":"4","key":"pone.0336766.ref024","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1007\/s11596-022-2553-0","article-title":"Evaluation of Left Ventricular Function by Three-Dimensional Speckle-Tracking Echocardiography in Patients with Chronic Kidney Failure","volume":"42","author":"Y-B Wang","year":"2022","journal-title":"Curr Med Sci"},{"key":"pone.0336766.ref025","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1007\/s10554-020-02100-3","article-title":"Left ventricular strain values using 3D speckle-tracking echocardiography in healthy adults aged 20 to 72 years","volume":"37","author":"FO Mutluer","year":"2020","journal-title":"The International Journal of Cardiovascular Imaging"},{"issue":"1","key":"pone.0336766.ref026","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.echo.2011.10.009","article-title":"Evaluation of global left ventricular systolic function using three-dimensional echocardiography speckle-tracking strain parameters","volume":"25","author":"P Reant","year":"2012","journal-title":"J Am Soc Echocardiogr"},{"issue":"4","key":"pone.0336766.ref027","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1093\/ehjci\/jeu213","article-title":"Normal reference values of left ventricular strain using three-dimensional speckle tracking echocardiography: results from a multicentre study","volume":"16","author":"SA Kleijn","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"7","key":"pone.0336766.ref028","doi-asserted-by":"crossref","first-page":"8034","DOI":"10.21037\/apm-21-1540","article-title":"Application of velocity vector imaging (VVI) in the evaluation of left ventricular myocardial contractile strain and dyssynchrony before and after stent implantation in patients with coronary heart disease","volume":"10","author":"D-X Zhu","year":"2021","journal-title":"Ann Palliat Med"},{"issue":"4","key":"pone.0336766.ref029","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s10554-016-1027-5","article-title":"Differentiation of light-chain cardiac amyloidosis from hypertrophic cardiomyopathy using myocardial mechanical parameters by velocity vector imaging echocardiography","volume":"33","author":"L Zhang","year":"2017","journal-title":"Int J Cardiovasc Imaging"},{"issue":"5","key":"pone.0336766.ref030","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s10916-019-1209-5","article-title":"Evaluation of eSie VVI Technology on Left Ventricular Systolic Function Changes in Uremic Patients Undergoing Dialysis","volume":"43","author":"Y Wang","year":"2019","journal-title":"J Med Syst"},{"issue":"1","key":"pone.0336766.ref031","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s12938-018-0536-y","article-title":"Ultrasonic image analysis of longitudinal strain in uremic patients with preserved left ventricular ejection fraction","volume":"17","author":"Y Ma","year":"2018","journal-title":"Biomed Eng Online"},{"issue":"5","key":"pone.0336766.ref032","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1007\/s10741-023-10318-1","article-title":"Implications of uremic cardiomyopathy for the practicing clinician: an educational review","volume":"28","author":"H Hiraiwa","year":"2023","journal-title":"Heart Fail Rev"},{"issue":"6","key":"pone.0336766.ref033","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s11926-014-0423-x","article-title":"Kawasaki disease: pathophysiology, clinical manifestations, and management","volume":"16","author":"VR Dimitriades","year":"2014","journal-title":"Curr Rheumatol Rep"},{"key":"pone.0336766.ref034","doi-asserted-by":"crossref","first-page":"899945","DOI":"10.3389\/fcvm.2022.899945","article-title":"Evaluation of left ventricular myocardial stratified strain in patients with Kawasaki disease using two-dimensional speckle tracking imaging","volume":"9","author":"J Hu","year":"2022","journal-title":"Front Cardiovasc Med"},{"issue":"6","key":"pone.0336766.ref035","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0100265","article-title":"Left ventricular myocardial function in hemodialysis and nondialysis uremia patients: a three-dimensional speckle-tracking echocardiography study","volume":"9","author":"R Chen","year":"2014","journal-title":"PLoS One"},{"issue":"5","key":"pone.0336766.ref036","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1007\/s00380-016-0900-4","article-title":"Relationships of left ventricular strain and strain rate to wall stress and their afterload dependency","volume":"32","author":"D Murai","year":"2017","journal-title":"Heart Vessels"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0336766","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T17:46:40Z","timestamp":1774028800000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0336766"}},"subtitle":[],"editor":[{"given":"Gaetano","family":"Santulli","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":36,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,20]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0336766","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,20]]}}}