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Changes of Left and Right Ventricle Mechanics and Function in Patients with End-Stage Renal Disease Undergoing

Eglė Tamulėnaitė1, Rūta Žvirblytė2, Rūta Ereminienė3

  • 1Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania. egletamulenaite@gmail.com.

Medicina (Kaunas, Lithuania)
|November 16, 2018
PubMed

Insights

Patients with end-stage renal disease (ESRD) on hemodialysis exhibit subclinical left and right ventricular dysfunction, even with preserved ejection fraction. Speckle-tracking echocardiography (STE) effectively detects these cardiac abnormalities in ESRD patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • Chronic kidney disease (CKD) significantly elevates cardiovascular disease risk.
  • Cardiac structural and functional abnormalities are common in CKD patients.
  • End-stage renal disease (ESRD) patients undergoing hemodialysis are particularly vulnerable to cardiac complications.

Purpose of the Study:

  • To evaluate left and right ventricle mechanics and function in ESRD patients on hemodialysis using speckle-tracking echocardiography (STE).
  • To identify subclinical cardiac dysfunction in ESRD patients with preserved left ventricle ejection fraction (LVEF).

Main Methods:

  • Retrospective study including 38 ESRD patients on regular hemodialysis and 32 age-matched healthy controls.
  • Conventional 2D echocardiography and STE were performed on all participants.
  • Assessment included left ventricle (LV) and right ventricle (RV) global longitudinal strain (GLS) and global circumferential strain (GCS).

Main Results:

  • ESRD patients showed significantly higher LV myocardial mass index and a high prevalence of LV diastolic dysfunction (LVDD) (81.6%).
  • Reduced LV GLS and GCS were observed in the hemodialysis group compared to controls.
  • RV free wall longitudinal function, including RV GLS, was significantly reduced in hemodialysis patients, although RV fractional area change (FAC) did not differ.

Conclusions:

  • Patients with ESRD on hemodialysis and preserved LVEF exhibit impaired LV longitudinal and circumferential deformation and reduced RV longitudinal function.
  • STE is a valuable tool for detecting subclinical LV and RV dysfunction in chronic hemodialysis patients.
  • Early detection of cardiac dysfunction may aid in managing cardiovascular risk in ESRD patients.

Keywords:
cardiac mechanicshaemodialysisspeckle-tracking echocardiography

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