Higher ultrafiltration rate is associated with right ventricular mechanical dispersion

Area of Science:

• Cardiology
• Nephrology
• Medical Imaging

Background:

• Ultrafiltration rate is a key factor in adverse outcomes for hemodialysis (HD) patients.
• Previous research examined HD's effect on right ventricular (RV) peak strain, but temporal deformation characteristics remained unexplored.

Purpose of the Study:

• To investigate the impact of high ultrafiltration rate (HUR) on RV mechanical dyssynchrony.

Main Methods:

• Echocardiography of RV and left ventricle (LV) in 60 HD patients before and after treatment.
• Two-dimensional speckle-tracking strain analysis to assess deformation.
• Measurement of mechanical dispersion via standard deviation of time to peak longitudinal strain.

Main Results:

• Global longitudinal strain (GLS) of RV and LV decreased post-HD in all patients.
• Significant increase in RV mechanical dispersion observed in the high ultrafiltration group.
• A slight, non-significant increase in LV mechanical dispersion was noted after HD.

Conclusions:

• High ultrafiltration rates significantly affect LV and RV GLS and RV dyssynchrony.
• Recommendations include minimizing ultrafiltration rates and volumes for improved hemodynamic stability and tolerability.