The diastolic function abnormalities in hemodialysis session: a two-dimensional speckle tracking echocardiographic...

Area of Science:

• Cardiology
• Nephrology
• Echocardiography

Background:

• Hemodialysis (HD) can decrease cardiac preload, but its acute impact on diastolic function remains debated.
• Conventional echocardiographic indices may be influenced by volume status, complicating assessment after HD.
• Newer non-volume-dependent indices are needed to accurately evaluate diastolic function post-HD.

Purpose of the Study:

• To evaluate acute changes in diastolic function following hemodialysis sessions using advanced echocardiographic techniques.
• To compare the effects of HD on conventional Doppler parameters versus two-dimensional speckle tracking echocardiography (2DSTE) findings.

Main Methods:

• 39 patients on chronic HD underwent transthoracic echocardiography before and after HD.
• Measurements included transmitral flow, tissue Doppler imaging, and 2DSTE for global longitudinal strain.
• Analysis focused on changes in diastolic parameters and their dependence on preload.

Main Results:

• Significant changes were observed in transmitral flow and tissue Doppler parameters post-HD (e.g., decreased E/A ratio, increased MPI).
• Global longitudinal strain measured by 2DSTE significantly worsened after HD.
• Diastolic strain ratios (DSRE, DSRA) showed no significant change post-HD.

Conclusions:

• Hemodialysis acutely affects diastolic function, as evidenced by changes in conventional Doppler parameters.
• 2DSTE-derived diastolic measurements may be less dependent on cardiac preload compared to traditional echocardiography.
• Further research is warranted to confirm the role of 2DSTE in assessing diastolic function in HD patients.