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[Effect of hemodialysis on left ventricular function in patients with chronic renal failure assessment with
J Starzyk1, W Grzeszczak, D Kowalski
1Oddziału Nefrologii, Slaskiej Akademii Medycznej, Zabrzu.
Insights
Hemodialysis (HD) improves left ventricular (LV) systolic function in chronic renal failure (CRF) patients, enhancing ejection fraction in specific LV sectors and increasing peak ejection rate. However, HD does not significantly alter LV filling in early diastole.
Area of Science:
- Cardiology
- Nephrology
- Medical Imaging
Context:
- Chronic renal failure (CRF) patients undergoing hemodialysis (HD) often experience cardiovascular complications.
- Left ventricular (LV) function is a critical indicator of cardiovascular health in these patients.
Purpose:
- To investigate the impact of HD on LV systolic and diastolic function in patients with CRF.
- To assess changes in global and sectorial LV ejection fraction (EF), peak ejection rate (PER), and diastolic filling parameters before and after HD.
Summary:
- Gated radionuclide ventriculography in 16 CRF patients and 12 controls revealed that HD did not change global EF but significantly improved EF in LV sectors 4 and 5.
- Peak ejection rate (PER) increased post-HD (p < 0.02), while time to end systole (TES) remained unchanged.
- Peak filling rate (PFR) was unaffected, but the time to peak filling rate (TPFR) increased (p < 0.02), indicating altered diastolic filling patterns.
Impact:
- HD demonstrates beneficial effects on LV systolic function in CRF patients.
- The findings suggest that HD can positively influence myocardial contractility in specific LV regions.
- HD does not appear to improve early diastolic filling of the left ventricle in CRF patients.
Abstract:
To examine the effects of haemodialysis (HD) on left ventricular (LV) function, gated radionuclide ventriculography was conducted before and after HD in 16 patients with chronic renal failure (CRF) and in 12 healthy persons. The LV sectorial function was assessed by subdividing the LV region of interest into 6 sectors. Global ejection fraction (EF) was unchanged by dialysis (61.4 +/- 8.3% before vs. 63.5 +/- 10.4% after) (mean +/- S.D.). EF of sectors 4 and 5 was improved significantly (69.3 +/- 10.7% and 85.6 +/- 17.1% before vs. 81.7 +/- 18.4% and 97.4 +/- 22.0% after) (p < 0.05 and p < 0.05). The peak ejection rate (PER) was increased following HD (3.07 +/- 1.03 EDc/s before vs. 3.88 +/- 0.88 EDc/s after) (p < 0.02). The time to end systole (TES) corrected for R-R interval was unchanged by HD (46.3 +/- 6.3 before vs. 43.8 +/- 5.3 after). The peak filling rate (PFR) was unchanged by HD (3.41 +/- 0.77 EDc/s before vs. 3.05 +/- 0.45 EDc/s after). The time to peak filling rate (TPFR) corrected for R-R interval was increased (21.8 +/- 5.3 before vs 25.9 +/- 5.0 after) (p < 0.02). This study indicates that HD produces beneficial effects on LV systolic function in CRF patients and does not improve LV filling in early diastole.