Related Experiment Video

Updated: Nov 9, 2025

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
09:32

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge

Published on: January 20, 2023

3.7K

Left ventricular myocardial function in hemodialysis patients: the effects of preload decrease in conventional,

Salma Charfeddine1, Leila Abid1, Rania Hammami1

  • 1Department of Cardiology, Hedi Chaker University Hospital, Sfax, Tunisia.

The Pan African Medical Journal
|April 15, 2021
PubMed

Insights

Speckle tracking imaging (STI) reveals subclinical left ventricular (LV) dysfunction in hemodialysis (HD) patients with preserved ejection fraction. A single HD session improved global strain values, indicating potential for early detection of LV dysfunction.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • Hemodialysis (HD) patients with preserved left ventricular ejection fraction (LVEF) may have subclinical myocardial dysfunction.
  • Conventional echocardiography and Doppler may not fully capture these subtle changes.

Purpose of the Study:

  • To assess left ventricular (LV) myocardial function in HD patients using conventional echocardiography, pulsed Doppler, and speckle tracking imaging (STI).
  • To evaluate the impact of a single HD session on LV systolic and diastolic functions.

Main Methods:

  • 30 chronic HD patients underwent echocardiography and Doppler studies before and after HD.
  • Two- and three-dimensional STI measured LV global longitudinal, circumferential, and radial strains.

Main Results:

  • HD led to significant decreases in LV dimensions, left atrium (LA) area, pulmonary artery pressure, and inferior vena cava diameter.
  • Mitral inflow velocities and E/E' ratio decreased post-HD, alongside reductions in LV/LA volumes and LV mass index.
  • While 3D-LVEF remained preserved, 2D and 3D strain rates decreased, yet global strain values improved post-HD.
  • Inverse correlations were observed between LV mass index, serum BNP, and LV global longitudinal strain.

Conclusions:

  • STI analysis provides valuable insights into subclinical LV dysfunction in HD patients with preserved LVEF.
  • STI may aid in the early detection and management of cardiac complications in this population.
Abstract

Keywords:
Hemodialysisechocardiographyleft ventricular functionspeckle tracking imagingstrain

More Related Videos

High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart11:50

High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart

Published on: July 9, 2010

24.4K
Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice12:12

Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice

Published on: February 14, 2017

16.4K

Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
160
Regulation of Stroke Volume01:27

Regulation of Stroke Volume

The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
4.4K
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.8K
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
588
Cardiac Output II: Effect of Stroke Volume on Cardiac Output01:22

Cardiac Output II: Effect of Stroke Volume on Cardiac Output

Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
2.2K