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Effect of maintenance hemodialysis on diastolic left ventricular function in end-stage renal disease

Mustafa Duran1, Aydin Unal, Mehmet Tugrul Inanc

  • 1Department of Cardiology, Etlik Ihtisas Research and Educational Hospital, Ankara, Turkey.

Clinics (Sao Paulo, Brazil)
|December 2, 2010
PubMed

Insights

Maintenance hemodialysis did not significantly alter left ventricular diastolic function in end-stage renal disease patients, though left atrial diameter increased. Left ventricular systolic function showed impairment post-hemodialysis.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • End-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (MHD) often exhibit cardiovascular complications.
  • Left ventricular (LV) diastolic dysfunction is a common comorbidity in ESRD.
  • The impact of MHD on LV diastolic function requires further elucidation.

Purpose of the Study:

  • To investigate the effects of MHD on LV diastolic function in patients with ESRD.
  • To assess changes in echocardiographic parameters before and after MHD initiation.

Main Methods:

  • A cohort of 42 ESRD patients were evaluated using conventional and Doppler echocardiography, including Doppler tissue imaging.
  • Echocardiographic assessments were performed before arteriovenous fistula creation and after the initiation of MHD (mean 76.14 ± 11.37 days).

Main Results:

  • While peak early (E) and late (A) diastolic mitral inflow velocities and the E/A ratio remained unchanged, deceleration time of the E wave and left atrial diameter significantly increased post-hemodialysis.
  • Early (Em) and late (Am) diastolic myocardial velocities and Em/Am ratios of the LV lateral and septal walls showed no significant alterations.
  • E/Em ratio decreased insignificantly, and pulmonary vein velocities and right ventricular functions remained largely unchanged.

Conclusions:

  • MHD treatment did not significantly alter LV diastolic function, except for an increase in left atrial diameter, and did not impact right ventricular functions in the studied ESRD patients.
  • Left ventricular systolic functions were found to be impaired following maintenance hemodialysis.
  • Echocardiography is a valuable tool for assessing cardiac function in ESRD patients, but serial assessment protocols post-hemodialysis need further standardization.
Abstract

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