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[Left ventricular function in patients under peritoneal dialysis treatment]
Insights
Peritoneal dialysis significantly improves cardiac function in patients with end-stage chronic renal failure. This treatment helps both dilated cardiomyopathy and asymmetric septal hypertrophy, enhancing overall heart health.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Context:
- End-stage chronic renal failure (CRF) often leads to significant cardiac complications.
- Left ventricular function can be compromised in CRF patients, presenting as dilated cardiomyopathy or asymmetric septal hypertrophy.
- Echocardiography is crucial for assessing cardiac morphology and function in CRF.
Purpose:
- To evaluate the impact of peritoneal dialysis (PD) on left ventricular function in patients with end-stage CRF.
- To assess changes in echocardiographic parameters before and after PD treatment.
- To identify specific cardiac patterns associated with CRF and their response to PD.
Summary:
- M-mode echocardiograms and systolic time intervals were analyzed in 24 end-stage CRF patients before and after PD.
- Patients exhibited patterns of dilated cardiomyopathy (Group A), asymmetric septal hypertrophy (Group B), or non-specific myocardial derangement (Group C).
- PD treatment led to improved contractile state in Group A, reduced septal hypertrophy in Group B, and enhanced cardiac performance in Group C.
Impact:
- End-stage CRF can manifest with distinct echocardiographic findings of cardiomyopathy.
- Peritoneal dialysis demonstrates significant efficacy in improving both morphological and functional cardiac derangements in CRF patients.
- This study highlights PD as a beneficial therapeutic option for managing cardiac complications associated with chronic kidney disease.
Abstract:
M-Mode echocardiogram and systolic time intervals were obtained in 24 patients with end-stage chronic renal failure before and after peritoneal dialysis in order to evaluate their left ventricular function. Before dialysis 9 patients (group A) showed an echocardiographic pattern of dilated cardiomyopathy, i.e. increased left ventricular end-diastolic dimension (EDD) and volume (EDV), reduction of fractional shortening (FS%), of circumferential fiber shortening (Vcf) and of ejection fraction (EF). Seven patients (group B) had the morphological and functional features of asymmetric septal hypertrophy: ratio of interventricular septum to posterior wall thickness (IVS/PWT) greater than 1.3, reduced EDD and EDV. Eight uraemics (group C) had no specific feature of cardiac disease, but only aspecific echocardiography signs of myocardial derangement. Peritoneal dialysis appeared to be associated with gradual improvement of the contractile state in group A patients, with reduction in echocardiographic asymmetric septal hypertrophy in group B uraemics, and with an aspecific increase in cardiac performance in group C patients. It is concluded that: end-stage chronic renal failure may have echocardiographic pattern of dilated or asymmetric hypertrophic cardiomyopathy; peritoneal dialysis significantly improves the morphological and functional derangements of both clinical conditions.