[Changes in the extent of mitral regurgitation during hemodialysis: color Doppler echocardiographic study]

The changes in the extent of mitral regurgitation (MR) during maintenance hemodialysis patients were studied in six patients with MR by color Doppler echocardiography. M-mode, two-dimensional and color Doppler echocardiography were performed before and every hour during hemodialysis. The severity of MR was evaluated by a semiquantitative grading system and maximal MR area. Hemodialysis removed 2.1 +/- 0.9/body fluid. Blood pressure and heart rate did not change systematically by hemodialysis. Left atrial, left ventricular end-diastolic and end-systolic dimensions were significantly decreased by hemodialysis (p < 0.05). Stroke volume and left ventricular wall stress were also significantly decreased (p < 0.01). MR area was significantly smaller at the end of hemodialysis compared to pre-hemodialysis (49.0 +/- 20.5 vs 171.0 +/- 49.2 mm2, p < 0.05). During hemodialysis, the extent of MR was continuously decreased. In two out of six patients, the MR jet disappeared. The extent of MR may depend on the fluid volume removed by hemodialysis because the MR area diminished more as more fluid was removed. No major disorders of the mitral complex were detected when the MR area was decreased rapidly to less than 60 mm2 in response to the removal of a small amount of fluid. The dry weight should be determined as the body weight when MR is as small as possible by color Doppler echocardiography.