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Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
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Echocardiographic parameters in patients with and without hypotension during dialysis.
Hoorak Poorzand1, Farzaneh Sharifipour2, Abdollah Kerachian3
1Vascular and Endovascular Surgery Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Journal of Cardiovascular and Thoracic Research
|October 11, 2021
Summary
Intradialytic hypotension during dialysis is linked to reduced cardiac function. Echocardiography, particularly Global Longitudinal Strain (GLS), can predict this common complication in hemodialysis patients.
Area of Science:
- Nephrology
- Cardiology
- Medical Imaging
Background:
- Intradialytic hypotension is a frequent and serious complication of hemodialysis.
- It is associated with increased mortality and morbidity in patients with chronic kidney disease.
- Current methods for prediction and management are limited.
Purpose of the Study:
- To compare cardiac function using echocardiography with strain imaging in hemodialysis patients with and without intradialytic hypotension.
- To evaluate the utility of echocardiographic parameters, including Global Longitudinal Strain (GLS), in predicting intradialytic hypotension.
Main Methods:
- A comparative study of 60 chronic renal failure patients undergoing hemodialysis.
- Patients were divided into an intradialytic hypotension group (n=30) and a control group (n=30).
- Transthoracic echocardiography with conventional, tissue Doppler, and strain imaging was performed one day post-hemodialysis.
Main Results:
- The intradialytic hypotension group showed significantly lower early diastolic mitral annulus velocity (e') compared to the control group (P=0.007).
- Left Ventricular Ejection Fraction (LVEF) was significantly reduced in the hypotension group (P < 0.001).
- Global Longitudinal Strain (GLS) was significantly lower in patients experiencing intradialytic hypotension (P < 0.001), with GLS ≤ -16.85 demonstrating 83% sensitivity and 87% specificity.
Conclusions:
- Echocardiographic assessment, especially GLS, serves as a valuable tool for predicting intradialytic hypotension in hemodialysis patients.
- Strain imaging can identify subtle cardiac dysfunction associated with intradialytic hypotension.
- This imaging modality may aid in proactive management and prevention strategies for intradialytic hypotension.
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