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Evidence of left ventricular systolic and diastolic dysfunction by color tissue Doppler imaging despite normal
Okan Gulel1, Korhan Soylu, Serkan Yuksel
1Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey. okangulel@hotmail.com
Insights
Patients undergoing hemodialysis show impaired left ventricular (LV) myocardial function. Color tissue Doppler imaging (TDI) revealed reduced systolic and early diastolic function in these patients with chronic kidney disease.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Background:
- Cardiovascular diseases are a leading cause of mortality in hemodialysis patients.
- Chronic renal failure requiring hemodialysis significantly impacts patient health outcomes.
Purpose of the Study:
- To evaluate left ventricular (LV) longitudinal myocardial function in hemodialysis patients.
- Utilize color tissue Doppler imaging (TDI) to assess these cardiac parameters.
Main Methods:
- Studied 31 hemodialysis patients and 23 healthy controls.
- Employed color TDI using apical views of the left ventricle.
- Measured various myocardial function parameters including strain and strain rate.
Main Results:
- Hemodialysis patients exhibited lower mean peak LV strain, systolic strain rate, and systolic tissue velocity.
- Early diastolic strain rate and tissue velocity were also reduced in the hemodialysis group.
- Late diastolic function parameters showed no significant difference between groups.
Conclusions:
- Regular hemodialysis is associated with significant alterations in LV longitudinal myocardial function.
- Color TDI is effective in detecting these functional changes in chronic renal failure patients.
Background:
Cardiovascular diseases are responsible for about half of deaths and are the major cause of mortality in hemodialysis patients. The aim of this study is to assess left ventricular (LV) longitudinal myocardial functions by color tissue Doppler imaging (TDI) in patients with chronic renal failure on a regular hemodialysis program.
Methods:
Thirty-one patients on a regular hemodialysis program (mean age 47 +/- 12 years; 17 males, 14 females) were included into the study. Twenty-three healthy subjects (mean age 44 +/- 8 years; 15 males, 8 females) were studied as a control group. The patients had been on maintenance hemodialysis for at least 1 month and hemodialysis sessions were three times per week. For color TDI, apical two- and four-chamber views of left ventricle were used. Sample volumes were placed on the mid-left ventricle in the inner half of the myocardium at the septum, lateral, inferior, and anterior walls. Peak LV strain, peak systolic strain rate, peak early diastolic strain rate, peak late diastolic strain rate, peak systolic tissue velocity, peak early diastolic tissue velocity, and peak late diastolic tissue velocity values were measured.
Results:
Mean peak LV strain, mean peak systolic strain rate, and mean peak systolic tissue velocity values were all lower in the hemodialysis group. Although mean peak late diastolic strain rate and mean peak late diastolic tissue velocity values were similar between the groups, mean peak early diastolic strain rate and mean peak early diastolic tissue velocity values were lower in the hemodialysis group.
Conclusion:
Patients with chronic renal failure on regular hemodialysis program show significant alterations at LV longitudinal myocardial function parameters assessed by color TDI.
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