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The effect of hemodialysis on left ventricular outflow tract gradient

Pawel Petkow Dimitrow1, Joanna Michałowska, Danuta Sorysz

  • 1Second Department of Cardiology CMUJ, Krakow, Poland. dimitrow@mp.pl

Echocardiography (Mount Kisco, N.Y.)
|April 24, 2010
PubMed

Insights

Hemodialysis (HD) can increase the left ventricular outflow tract gradient (LVOTG), particularly when a longer pause between treatments leads to greater fluid shifts. This effect is more pronounced when patients stand up after HD.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • Hemodialysis (HD) patients often experience fluid overload.
  • Left ventricular outflow tract gradient (LVOTG) can be affected by fluid status.

Purpose of the Study:

  • To evaluate the impact of hemodialysis on LVOTG.
  • To assess if LVOTG changes differ based on the duration of the pause between HD sessions.
  • To investigate the role of patient positioning (supine vs. upright) in LVOTG changes post-HD.

Main Methods:

  • Echocardiography was used to measure LVOTG in 41 chronic HD patients.
  • Measurements were taken before and after HD, in both supine and upright positions.
  • HD sessions followed either a short (1-day) or long (2-day) pause.

Main Results:

  • After a long pause, standing significantly increased LVOTG post-hemodialysis.
  • LVOTG changes after a short pause were less significant.
  • Greater ultrafiltration volume was observed after longer pauses, correlating with increased LVOTG upon standing.

Conclusions:

  • Hemodialysis can predispose patients to a standing-provoked increase in LVOTG.
  • Longer intervals between HD sessions exacerbate this effect due to increased hypervolemia and fluid removal.
  • The findings highlight the importance of considering fluid status and patient positioning in managing LVOTG in HD patients.
Abstract

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