Left ventricular function in uremia: echocardiographic assessment in patients on maintenance dialysis

Echocardiographic assessment of left ventricular function was performed in twenty-two unselected patients on stable, chronic maintenance dialysis. The statistically significant abnormalities were enlargement of the left ventricular cavity (end diastolic internal dimension or "diameter" 5.4 +/- 0.2 cm, normal 4.4 +/- 0.3 cm), thickening of the left ventricular wall (end diastolic thickness 1.1 +/- 0.05 cm, normal 0.9 +/- 0.03 cm) and a reduction in myocardial contraction (fractional shortening 28.2 +/- 2.0%, normal 35.7 +/- 0.9%). Myocardial impairment could not be attributed to the effects of hypertension or to ischemic heart disease. There was, however, a significant negative correlation between fractional shortening and total plasma catecholamines (r = 0.45, P less than 0.05) suggesting that excessive catecholamines may contribute to the decreased myocardial contraction seen in uremic patients.