[Echopolycardiographic evaluation of left ventricular function after hemodialysis]

The acute effects of haemodialysis on left ventricular (LV) function were studied by echocardiography and systolic time intervals in 19 patients maintained on long-term haemodialysis. Dialysis resulted in a significant reduction in body weight, an increase in heart rate and a small reduction in systolic blood pressure. A significant decrease was observed in LV diastolic and systolic dimensions, with an increase in the mean rate of circumferential shortening (mean VCF). The LV ejection time (LVET) decreased significantly, while changes in the pre-ejection period (PEP) were insignificant. The PEP/LVET ratio increased in all patients. Haemodialysis reduced the serum potassium levels; an increase was noted in the serum calcium concentrations, with a significant, although small, correction of blood pH. The major haemodynamic change induced by dialysis was a decrease in blood volume with a reduction in LV pre-load. These changes are suggested by the reduction in body weight and by the shortening in LV end-diastolic dimension and LVET. There was also a reduction in after-load, as expressed by the shortening in LV systolic diameter and by the decrease in systolic blood pressure. It should be emphasized that the study of LV function in patients on chronic dialysis is greatly influenced by the loading conditions. In such patients the assessment of LV function by echocardiography and systolic time intervals provides information regarding the haemodynamic changes induced by dialysis; however, no direct evidence can be derived about the functional state of the left ventricle.