Evaluation of the effect of duration on dialysis on echocardiographic parameters: a preliminary study
Fedoua Ellouali1, Fatimazahra Berkchi, Siham Elhoussni
1Cardiology "B" Department, CHU Ibn Sina; Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of Medicine and Pharmacy, University Mohammed V, Souissi, Rabat, Morocco.
Insights
Longer dialysis duration in end-stage renal disease patients is linked to significant changes in echocardiographic parameters, including left ventricular mass and size. Regular echocardiogram monitoring is crucial for managing these patients.
Area of Science:
- Nephrology
- Cardiology
- Medical Imaging
Background:
- End-stage renal disease (ESRD) patients exhibit high cardiovascular mortality, often linked to accelerated coronary atherosclerosis.
- Echocardiographic parameters like left ventricular mass and diastolic dysfunction are implicated in ESRD ventricular dysfunction and mortality.
Purpose of the Study:
- To investigate the impact of hemodialysis duration on specific echocardiographic parameters in ESRD patients.
Main Methods:
- Prospective study of 75 ESRD patients on hemodialysis (mean age 42.5 ± 13.8 years).
- Patients divided into two groups: <5 years on dialysis (Group-1) and >5 years on dialysis (Group-2).
- Echocardiographic parameters measured within 2 hours post-dialysis; groups compared using univariate analysis.
Main Results:
- Statistically significant differences observed between groups in left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular mass, inter-ventricular septum, mitral flow deceleration time, tricuspid anteroposterior systolic excursion, inferior vena cava diameter, left atrial size, valvular calcification, and pericardial effusion.
- Demographics and cardiovascular risk factors were similar between groups.
Conclusions:
- Hemodialysis duration is associated with alterations in multiple echocardiographic parameters in ESRD patients.
- Recommends frequent echocardiogram follow-up for effective management of cardiovascular changes in this population.
Abstract:
The excessive cardiovascular mortality seen in patients with end-stage renal disease seems to be closely related to accelerated coronary atherosclerosis. Some echocardiographic parameters such as left ventricular mass and diastolic dysfunction are implicated in ventricular dysfunction and mortality. The aim of the present study was to evaluate the effect of duration on dialysis on some echocardiographic parameters. We enrolled 75 patients on hemodialysis, including 34 women, in our prospective study. The mean age was 42.5 ± 13.8 years. The echocardiographic parameters were all measured within 2 h after a dialysis session. The study population was divided into two groups: Group-1 consisted of patients on dialysis for < 5 years and group-2 included patients on dialysis for >5 years. The two groups were similar regarding demographic characteristics and cardiovascular risk factors. On univariate analysis, a statistically significant difference was seen in the left ventricular end-diastolic diameter (P = 0.002), left ventricular end-syslotic diameter (P = 0.008), left ventricular mass (P = 0.006), inter-ventricular septum (P = 0.024), mitral flow deceleration time (P = 0.03), tricuspid anteroposterior systolic excursion (P = 0.01), inferior vena cava diameter (P = 0.04), left atrial size (P = 0.02), valvular calcification (P = 0.01) and pericardial effusion (P = 0.01) between the two groups. We conclude that the duration on dialysis is associated with changes in several echocardiographic parameters. Frequent follow-up with echocardiogram is recommended in the management of these patients.
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