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[Structural-functional alterations in the heart affecting dynamics of transmitral blood flow during a hemodialysis

A M Shutov, O M Edigarov, V E Mastykov

    Terapevticheskii Arkhiv
    |August 8, 2006
    PubMed

    Insights

    Hemodialysis (HD) alters transmitral circulation (TMC) dynamics in chronic renal failure (CRF) patients, with changes depending on initial diastolic dysfunction. HD sessions can improve intracardiac hemodynamics in patients with pseudonormal TMC.

    Area of Science:

    • Cardiology
    • Nephrology
    • Medical Imaging

    Context:

    • Patients with chronic renal failure (CRF) undergoing hemodialysis (HD) often exhibit cardiac structural-functional alterations.
    • Diastolic dysfunction of the left ventricular (LV) myocardium is prevalent in CRF patients.
    • Transmitral circulation (TMC) dynamics can reflect these cardiac changes.

    Purpose:

    • To investigate the impact of a hemodialysis session on transmitral circulation (TMC) dynamics.
    • To correlate TMC changes with structural-functional cardiac alterations and baseline diastolic function in CRF patients.
    • To assess how baseline diastolic dysfunction influences TMC alterations during HD.

    Summary:

    • Eighty-two percent of CRF patients had LV hypertrophy, and 68.9% showed diastolic dysfunction.
    • HD did not significantly alter TMC in patients with normal diastolic function.
    • Patients with disturbed relaxation showed improved early diastolic flow velocity, while those with pseudonormal or restrictive TMC experienced decreased E peak velocity during HD.

    Impact:

    • Hemodialysis session outcomes on TMC are primarily dictated by the initial type of diastolic dysfunction, not LV geometry.
    • Hemodialysis can positively influence intracardiac hemodynamics in CRF patients presenting with pseudonormal TMC.
    • Findings highlight the importance of assessing diastolic function to predict TMC response to HD.
    Abstract

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