Objective To evaluate the left ventricular myocardial stratification strain in uremic patients by two-dimensional speckle tracking imaging（STI）technique.MethodsSixty uremic patients who comfired by clinical and pathologicalexamination and 60 healthy volunteers were enrolled in

and they were divided into the case group and the control group.The leftventricular end-diastolic volume（LVEDV）

left ventricular end-systolic volume（LVESV）

left ventricular end diastolicposterior wall thickness（LVPW）and interventricular septal thickness（IVS）and left ventricular ejection fraction（LVEF）weremeasured by two-dimensional echocardiography.The longitudinal strain peaks（LS）

circumferential strain peaks（CS）

and theaverage value of hoop stratified strain（GLS

GCS） were assessed at endocardium

mid-myocardium and epicardium weremeasured by stratified strain technique in the left ventricular two-chamber

three-chamber and four-chamber cardiac sections.The difference between each strain to obtain the overall longitudinal and hoop stratified strain across the wall strain gradient（△GLS

△GCS）of the left ventricle were calculated.ResultsNo significant difference of LVEDV

LVESV

LVPW

IVSand LVEF between two groups was found.The GLS of left ventricular myocardium in both groups decreased from endocardiumto epicardium

and signifcantly increased from basal to apical segment（P<0.05）.The GLS and △GLS of each layer of two-chamber

three-chamber and four-chamber cardiac sections in the case group were lower than those in the control group（allP<0.05）.There was no significant difference in CS

GCS and △GCS of basal

middle and apical segments between the two groups.ConclusionIn patients with uremia

the left ventricular myocardium and systolic function had been damaged before the LVEFis reduced. The systolic function of the whole layer of myocardium is reduced to varying degrees

and the subendocardialmyocardial function is most severely damaged. STI can sensitively reflect the changes of left ventricular systolic function inpatients with uremia.