Left Ventricular Function in Patients on Maintenance Hemodialysis: A Three-Dimensional Speckle-Tracking Imaging Study

Area of Science:

• Cardiology
• Nephrology
• Medical Imaging

Background:

• End-stage renal disease (ESRD) patients on maintenance hemodialysis (MHD) have high morbidity despite preserved ejection fraction.
• Left ventricular (LV) structural and functional changes are common but often asymptomatic in ESRD.

Purpose of the Study:

• To identify LV structural and functional abnormalities in ESRD patients on MHD using 3D speckle-tracking imaging (3D-STI).

Main Methods:

• Eighty-five ESRD patients (55 MHD, 30 non-dialysis) and 30 controls were assessed.
• Conventional echocardiography and 3D-STI measured LV mass and global strain parameters (GLS, GCS, GAS, GRS).

Main Results:

• LV hypertrophy was common in ESRD patients.
• MHD patients showed significantly higher LV mass index compared to non-dialysis and control groups.
• MHD patients exhibited significantly reduced GLS, GCS, GAS, and GRS, indicating impaired LV deformation.

Conclusions:

• MHD exacerbates LV deformation and dysfunction in ESRD patients, even with preserved LVEF.
• 3D-STI is a valuable tool for detecting these preclinical LV abnormalities in ESRD patients.