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[Changes in the left ventricular function in hemodialyzed patients. Role of Doppler echocardiography]
M Cavarra1, P Lo Giudice, P Statella
1Servizio di Cardiologia POU S. Luigi-S. Currò, Regione Sicilia-USL n. 34--Catania.
Insights
Dialysis significantly alters left ventricular diastolic function, reducing early filling and impacting relaxation. These changes, observed via Doppler, suggest potential cardiac effects in renal failure patients.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Context:
- Patients with renal failure undergoing dialysis experience fluid shifts and hemodynamic changes.
- Left ventricular diastolic function is crucial for maintaining cardiac output and can be affected by chronic kidney disease and its treatments.
- Echocardiography with Doppler is a non-invasive tool for assessing cardiac function, including diastolic parameters.
Purpose:
- To investigate the impact of dialysis on left ventricular diastolic function using Doppler echocardiography.
- To analyze changes in specific diastolic indexes (e.g., E, A waves, dLA, dSLV, dDLV) before and after dialysis.
- To determine if observed diastolic alterations are indicative of myocardial compromise.
Summary:
- Dialysis led to significant reductions in dLA (p=0.032) and dDLV (p=0.029), indicating altered ventricular filling.
- Doppler indexes showed reduced early ventricular refilling (E wave) and a slight increase in late refilling (A wave).
- These changes suggest impaired ventricular relaxation and preload reduction, not necessarily myocardial damage, in the studied renal failure patients.
Impact:
- The study highlights significant, albeit non-myocardial, diastolic function alterations induced by dialysis in renal failure patients.
- Findings underscore the importance of monitoring cardiac function in dialysis patients.
- Further research with larger cohorts and follow-up is recommended for comprehensive understanding and personalized treatment strategies.
Abstract:
The aim of this study was to provide a further contribution to the study on the alterations of left ventricular diastolic function induced by dialysis, using simple indexes of diastolic function obtained with Doppler. The study is conduced in 15 patients with renal failure aged between 22 and 51 years old by means of echocardiography M-2D a pulsed Doppler analysis of the left ventricular refilling flow, evaluated before and after dialysis. By the results is risen up that the dLA has had a significant reduction (p = 0.032), the dSLV have undergone a reduction that is not being significant, while the dDLV has had a significant reduction (p = 0.029), shortening fraction is improved even if in a not significant manner. Also the Doppler indexes has had a behaviour homogeneous in the group of studied patients. Early ventricular refilling is reduced, as showed by the reduction of E, consequence of the reduction preload, while the diastolic late refilling has showed a little increment, expressed by the increase af the peak A. The variations of these indexes, even if not statistically significant, express an alteration of pattern diastolic Doppler caused by both the reduction of preload and the alteration of ventricular relaxation. Besides this alteration, to our notice, is not to consider expression of myocardial compromise in this group studied patients. It would be however useful enlargement of the study to greater number of patients with follow-up for better comprehension of this cardiopathy and makes a more individual treatment of these patients.