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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Cardiac Remodelling in Patients Undergoing in-Centre Nocturnal Haemodialysis: Results from the MIDNIGHT Study, a

Matthew P M Graham-Brown1, Darren R Churchward, Katherine L Hull

  • 1National Centre for Sport and Exercise Medicine, Loughborough, UK.

Blood Purification
|October 31, 2017
PubMed

Insights

Extended-hours haemodialysis (HD) offers significant cardiovascular benefits. In-centre nocturnal haemodialysis (INHD) improved left ventricular remodelling and reduced myocardial fibrosis compared to conventional HD.

Area of Science:

  • Nephrology
  • Cardiology
  • Medical Imaging

Background:

  • Extended-hours haemodialysis (HD) may enhance patient outcomes.
  • In-centre nocturnal haemodialysis (INHD) is an underutilized HD method.
  • Cardiovascular health is a key concern for HD patients.

Purpose of the Study:

  • To assess the impact of INHD on left ventricular (LV) structure, function, and myocardial fibrosis.
  • To compare INHD with conventional HD regarding cardiovascular and clinical markers.
  • To evaluate changes in quality-of-life and clinical measures.

Main Methods:

  • A 6-month, non-randomized controlled trial comparing 13 INHD patients with 12 conventional HD controls.
  • Cardiac magnetic resonance imaging and native T1 mapping were used to assess LV remodelling and fibrosis.
  • Quality-of-life questionnaires and clinical parameters were collected.

Main Results:

  • INHD significantly reduced LV mass (p=0.02) and global T1 values (p=0.05) compared to controls.
  • Significant reductions in non-septal native T1 values (p=0.02) indicated decreased myocardial fibrosis with INHD.
  • INHD also improved serum phosphate levels (p=0.03) and reduced ultrafiltration rates (p=0.05).

Conclusions:

  • Six months of INHD promotes favorable left ventricular remodelling.
  • INHD is associated with reduced myocardial fibrosis compared to conventional HD.
  • INHD shows potential for improving cardiovascular health in dialysis patients.

Keywords:
Cardiac MRILeft ventricular massMyocardial fibrosisNative T1Nocturnal haemodialysis

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