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Related Experiment Videos

Improved left ventricular contractility with cool temperature hemodialysis.

F L Levy1, P A Grayburn, C J Foulks

  • 1Department of Internal Medicine, Veterans Affairs Medical Center, Dallas, Texas.

Kidney International
|April 1, 1992
PubMed
Summary

Cool temperature dialysis (CTD) improves heart function during hemodialysis. This method enhances left ventricular contractility, potentially explaining its effectiveness in preventing hypotension during treatment.

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Area of Science:

  • Nephrology
  • Cardiology
  • Physiology

Background:

  • Cool temperature dialysis (CTD) reduces intradialytic hemodialysis hypotension.
  • The mechanism behind CTD's hemodynamic protection remains unclear.

Purpose of the Study:

  • To investigate the effect of CTD on left ventricular contractility.
  • To explore the potential mechanism of hemodynamic protection offered by CTD.

Main Methods:

  • Two-dimensional echocardiography was used to assess left ventricular contractility in six hemodialysis patients.
  • Left ventricular function was evaluated by plotting the rate-corrected velocity of circumferential fiber shortening (Vcfc) against end-systolic wall stress (sigma es) before and after dialysis at 37°C (RTD) and 35°C (CTD).

Main Results:

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  • Post-dialysis Vcfc was significantly higher after CTD compared to RTD (1.13 ± 0.29 vs. 0.98 ± 0.30 circ/sec, P = 0.0004).
  • The Vcfc–sigma es relation shifted upward post-CTD, indicating increased left ventricular contractility.
  • No significant changes in mean arterial pressure or heart rate were observed post-dialysis for either RTD or CTD.

Conclusions:

  • Cool temperature dialysis enhances left ventricular contractility in hemodialysis patients.
  • Increased contractility may be the mechanism improving hemodynamic tolerance during CTD.