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Updated: Dec 21, 2025
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Longitudinal changes of left and right cardiac structure and function in patients with end-stage renal disease on
Luca Arcari1, Giuseppino Massimo Ciavarella2, Silvia Altieri3
1Cardiology Unit, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy; Department of Cardiology, Madre Giuseppina Vannini Hospital, Rome, Italy.
Insights
Longitudinal echocardiograms in chronic kidney disease (CKD) patients on dialysis reveal worsening right ventricular (RV) dilation and diastolic dysfunction. Left ventricular ejection fraction (LVEF) also declined over time.
Area of Science:
- Cardiology
- Nephrology
- Echocardiography
Background:
- Limited data exist on cardiac structure and function changes in end-stage chronic kidney disease (CKD).
- Serial echocardiographic findings in dialyzed CKD patients are not well-described.
Purpose of the Study:
- To describe longitudinal changes in cardiac structure and function using echocardiography.
- To evaluate serial echocardiographic findings in a cohort of patients with end-stage CKD undergoing dialysis.
Main Methods:
- Retrospective longitudinal study including 120 dialyzed CKD patients.
- Patients underwent at least two echocardiograms over 1, 2, or 3 years.
- Echocardiographic assessment included Tissue Doppler Imaging of left and right ventricles.
Main Results:
- Right ventricle (RV) progressively dilated over 3 years (p=0.002).
- Left ventricular (LV) diastolic dysfunction worsened, indicated by increasing E/E' (p<0.001).
- RV systolic function declined (RV S wave decrease, p<0.001), and LV ejection fraction (LVEF) progressively decreased (p=0.034).
Conclusions:
- Dialyzed CKD patients exhibit parallel worsening of LV diastolic and RV systolic function.
- Progressive RV dilation accompanies functional decline in this cohort.
- LVEF reduction was less pronounced compared to diastolic and RV systolic dysfunction.
Background:
Few data are available regarding longitudinal changes of cardiac structure and function in end-stage chronic kidney disease (CKD). Aim of the present study is to describe serial echocardiographic findings in a cohort of dialyzed CKD patients.
Methods:
In this retrospective longitudinal study, we included n = 120 dialyzed CKD patients who underwent at least 2 echocardiograms either 1, 2 or 3 years apart. After baseline echocardiogram, n = 112 had a further examination at year 1, n = 76 at year 2 and n = 45 at year 3. Echocardiographic examination included Tissue Doppler Imaging of both left (LV) and right (RV) ventricle.
Results:
LV geometry and LV mass index did not significantly change over time. RV progressively dilated (mean change +1.3 mm, +1.1 mm and +3.1 mm at year 1, 2 and 3 respectively, p = 0.002, adjusted p = 0.003). Tissue Doppler parameters showed significant changes with regard to both LV (mean change of E/E' +0.7, +1.3, +1.7 at year 1, 2 and 3 respectively p<0.001, adjusted p = 0.079) and RV (mean change of S wave (cm/sec) -1, -1.7, -2 at year 1, 2 and 3 respectively, p <0.001, adjusted p = 0.041). Decrease of RV S wave negatively correlated with E/E' changes (r=-0.303, p = 0.002; r=-0.246, p = 0.049; r=-0.265, p = 0.089; at year 1, 2 and 3 respectively). LV ejection fraction (LVEF) progressively declined (p = 0.034, adjusted p = 0.140), albeit being significant lower against baseline only at year 3 (mean change -4.3%, p<0.05).
Conclusions:
In dialyzed CKD patients we observed parallel worsening of LV diastolic and RV systolic function accompanied by RV dilation. LVEF decreased less sharply.
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