Global longitudinal strain is superior to ejection fraction for detecting myocardial dysfunction in end-stage renal disease with hyperparathyroidism

Figure 1 Illustrative 2D echocardiography. Top: control patient; Bottom: patient with end-stage renal disease (ESRD) and severe hyperparathyroidism (SHPTH). The ejection fraction (EF) by the Simpson method was calculated as a function of the endocardial borders at end-diastole and end-systole in the apical projection of two cavities. A and C (left): in the control patient, left ventricular EF (LVEF) was 56% (A), and 61% in the patient with ESRD and SHPTH (C). 2D ECHO ST real-time showed longitudinal deformation (B and D, right). The deformation pattern in the control patient (B) was normal, with global longitudinal strain (GLS) = 19%, and GLS was abnormal (14%) in the patient with ESRD and SHPTH (D).