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Multidirectional myocardial systolic function in hemodialysis patients with preserved left ventricular ejection

Hong Wang1, Jie Liu, Xiao-dan Yao

  • 1Department of Ultrasound Diagnostics, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|May 8, 2012
PubMed

Insights

Hemodialysis patients with left ventricular (LV) hypertrophy show impaired longitudinal and circumferential myocardial function, even with preserved ejection fraction (LVEF). Low longitudinal strain is linked to LV hypertrophy and higher blood pressure.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • Multidirectional myocardial strain analysis offers insights into ventricular systolic function and pathophysiology.
  • Left ventricular (LV) geometry significantly influences cardiac function in patients with end-stage renal disease (ESRD).

Purpose of the Study:

  • To assess multidirectional systolic function of the LV in hemodialysis patients with preserved left ventricular ejection fraction (LVEF).
  • To investigate the relationship between LV systolic function and LV geometry in this patient cohort.

Main Methods:

  • Two-dimensional speckle tracking echocardiography was used for multidirectional strain analysis.
  • 98 ESRD patients on hemodialysis with preserved LVEF (≥50%) and 18 healthy controls were studied.
  • Patients were categorized into non-hypertrophic and hypertrophy groups based on LV geometry.

Main Results:

  • Myocardial systolic strain (longitudinal and circumferential) and stress-corrected midwall fraction shortening (sc-MWFS) were reduced in hypertrophy groups.
  • Concentric hypertrophy showed lower longitudinal strain and strain rate compared to eccentric hypertrophy.
  • Impaired longitudinal strain correlated with increased LV mass index, relative wall thickness, pre-dialysis systolic blood pressure, and calcium-phosphate product.

Conclusions:

  • Hemodialysis patients with LV hypertrophy exhibit impaired longitudinal and circumferential myocardial function, despite preserved LVEF.
  • Low longitudinal strain is associated with LV hypertrophy, concentric geometry, and pre-dialysis blood pressure.
  • Radial myocardial function remained unaffected across all groups.
Abstract

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