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Updated: Jul 9, 2026
Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Effect of preload reduction on sonographic myocardial integrated backscatter
Andrzej Minczykowski1, Danuta Zaremba-Drobnik, Irena Pietrzak
1Department of Cardiology-Intensive Therapy, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland.
Insights
Hemodialysis (HD) reduces cardiac cycle-integrated backscatter (CV-IBS), a measure of myocardial tissue. This decrease in CV-IBS is linked to reduced left ventricular preload and performance during HD.
Area of Science:
- Cardiovascular Imaging
- Biomedical Engineering
- Nephrology
Background:
- Myocardial tissue characterization using integrated backscatter (IBS) ultrasonography provides insights into cardiac structure and function.
- Hemodialysis (HD) significantly impacts cardiovascular hemodynamics, including preload and left ventricular performance.
Purpose of the Study:
- To evaluate the effect of preload reduction induced by hemodialysis (HD) on sonographic myocardial tissue characterization using integrated backscatter (IBS).
- To assess changes in cardiac cycle-integrated backscatter (CV-IBS) and calibrated IBS (cal-IBS) before and after HD sessions.
Main Methods:
- Echocardiography was performed on 52 patients undergoing maintenance HD before and after a dialysis session.
- Measurements included cardiac cycle-integrated backscatter (CV-IBS) and calibrated IBS (cal-IBS) to assess myocardial tissue properties.
Main Results:
- Hemodialysis resulted in significant reductions in left ventricular dimensions, atrial diameter, stroke volume, and ejection fraction, indicating preload reduction.
- Cardiac cycle-integrated backscatter (CV-IBS) significantly decreased in multiple ventricular walls post-HD (p < 0.01).
- Calibrated IBS (cal-IBS) showed no significant change, and CV-IBS correlated with ultrafiltration volume.
Conclusions:
- Hemodialysis-induced preload reduction leads to a significant decrease in cardiac cycle-integrated backscatter (CV-IBS).
- The observed changes in CV-IBS suggest a preload-dependent alteration in myocardial tissue characteristics during hemodialysis.
- These findings correlate with diminished left ventricular performance observed during HD sessions.
Purpose:
Sonographic myocardial tissue characterization with integrated backscatter (IBS) is affected by both structural and functional properties of the myocardium. The aim of the present study was to investigate the effect of preload reduction by hemodialysis (HD) on IBS measurements.
Methods:
Fifty-two patients on maintenance HD underwent echocardiography before and after a routine HD session. Measurements included the variation of IBS during the cardiac cycle (CV-IBS) and calibrated IBS (cal-IBS).
Results:
After HD, there were significant reductions in left ventricular end-diastolic and end-systolic dimensions and left atrial diameter. There was a reduction in stroke volume and LV ejection fraction consistent with a reduction in preload. Furthermore, CV-IBS was significantly lower after HD (7.9 +/- 2.2 versus 6.9 +/- 1.8 dB, 7.0 +/- 2.1 versus 6.2 +/- 1.9 dB, and 9.0 +/- 2.6 versus 8.1 +/- 2.0 dB [p < 0.01], respectively, in the left anterior, lateral, and inferior wall of the ventricle). Cal-IBS remained unchanged after dialysis compared with baseline. CV-IBS and ultrafiltration volume were significantly correlated.
Conclusion:
HD leads to a decrease in CV-IBS that appears to be preload-dependent. This finding is in concordance with diminished left ventricular performance during HD.
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