Related Experiment Video

Updated: Oct 27, 2025

A Murine Model of Hemodialysis Access-Related Hand Dysfunction
08:39

A Murine Model of Hemodialysis Access-Related Hand Dysfunction

Published on: May 31, 2022

1.8K

Left ventricular strain and left atrial strain are impaired during hemodialysis in children

Tam T Doan1, Poyyapakkam Srivaths2, Asela Liu3

  • 1The Lillie Frank Section of Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, MC E1920, Houston, TX, 77030, USA. tam.t.doan@gmail.com.

The International Journal of Cardiovascular Imaging
|July 21, 2021
PubMed

Insights

Pediatric hemodialysis patients showed worsening ventricular and atrial function during treatment, indicating subclinical dysfunction. These changes were not linked to fluid removal or blood pressure drops, suggesting disease progression impacts cardiac health.

Area of Science:

  • Cardiology
  • Pediatric Nephrology
  • Medical Imaging

Background:

  • Children undergoing chronic hemodialysis (HD) face risks of cardiovascular complications.
  • Assessing intradialytic cardiac function changes is crucial for understanding long-term outcomes.
  • Speckle tracking echocardiography (STE) offers advanced methods for evaluating ventricular and atrial mechanics.

Purpose of the Study:

  • To investigate intradialytic changes in ventricular and atrial function in pediatric patients on hemodialysis using STE.
  • To analyze alterations in left ventricular global longitudinal strain (GLS), diastolic strain (Ds), and left atrial strain (LAS) during HD sessions.
  • To explore the association between these cardiac function changes and blood pressure (BP) variations or fluid removal.

Main Methods:

  • A prospective study involving pediatric patients with HD vintage > 3 months.
  • Echocardiography with STE performed pre-HD, mid-HD, and post-HD.
  • Calculation of LV GLS, Ds, and LAS using GE EchoPAC software.

Main Results:

  • GLS significantly worsened during HD (p < 0.001) and was associated with BP decrease post-HD (p=0.01).
  • LV diastolic strain (Ds) progressively worsened during HD (p < 0.001).
  • Left atrial strain (LAS) changes observed mid-HD returned to baseline post-HD; Ds, DSr, LAS, and LASr were not associated with fluid removal or BP decrease (p > 0.1).

Conclusions:

  • Intradialytic changes in LV strain and LAS indicate subclinical systolic and diastolic dysfunction in children undergoing HD.
  • Observed cardiac function alterations may be linked to disease progression rather than acute intradialytic factors like BP changes or fluid removal.
  • Longitudinal studies using these novel STE indices are needed to clarify the long-term cardiovascular impact in pediatric HD patients.

Keywords:
Diastolic strainLeft atrial strainMechanical dispersion indexPediatric hemodialysisSpeckle tracking echocardiography

More Related Videos

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

16.3K
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

Related Concept Videos

Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
215
Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
504
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
316
Dialysis01:27

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
767
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...
114
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
97