[The effect of blood pressure changes during hemodialysis on left ventricular systolic function]

Echocardiographic study was performed in 31 uremic patients on maintenance hemodialysis (HD) with no apparent heart failure, valvular heart disease, pericardial effusion or coronary artery disease. On the basis of blood pressure patients were classified into two groups: 1) patients with normal arterial pressure (group I) (n = 19), 2) patients with blood hypertension (group II) (n = 12). Cardiac function was assessed immediately before and after HD session. Left ventricular end-diastolic diameter (EDD), left ventricular end-systolic diameter (ESD) and ejection fraction (EF) were calculated. Body weight, heart rate and mean blood pressure (mBP) were also measured. A significant decrease of EDD was noted in both groups during HD but it was less evident in group II (p < 0.05). ESD decreased significantly in group II (p < 0.01) when it did not change in group I. EF increased significantly only in group II (p < 0.05). Blood pressure decreased during HD in both groups. A significant inverse linear association between EF and ESD was noted during HD in both groups (r = -0.685; p < 0.001) but was more evident in group II. There was no association between and EDD (r = 0.199; NS). Similar analysis shows that ESD was significantly with mBP (group II--r = 0.914; p < 0.001, group I--r = 0.565; p < 0.05). Such association were not found for EDD and RR. Only in group II the decrease in mBP was statistical significantly correlated with the increase in EF. The decrease in EDD during HD exists probably due to changes in intravascular volume.(ABSTRACT TRUNCATED AT 250 WORDS)