Left ventricular performance in cases with chronic renal failure. A study of systolic time intervals

Left ventricular (LV) functions as reflected in systolic time intervals (STIs) were studied in 28 patients with chronic renal failure (CRF) and in an equal number of age and sex matched normal controls. Measurement of STIs revealed that mean total electromechanical systole (QS2) and left ventricular ejection time (LVET) were significantly decreased, whereas isovolumic contraction time (IVCT) was significantly increased in patients with CRF as compared to controls. Mean PEP/LVET ratio did not show any significant change. Eleven cases of CRF had congestive heart failure, and in 9 of them the PEP/LVET ratio was normal. Seven cases of CRF had evidence of left ventricular dysfunction (PEP/LVET greater than 0.4). In 6 cases, STIs were also recorded following dialysis, and revealed an increase in PEP, IVCT and PEP/LVET and a decrease in QS2 and LVET, but none of these changes were statistically significant. It is concluded that only a small percentage of cases of renal failure show LV dysfunction. However, signs of congestion are seen in a greater number of cases. These are not necessarily indicative of LV dysfunction but may be due to fluid and electrolyte overloading.