Related Experiment Videos
[Echocardiographic evaluation of left ventricular size and function in children with arterial hypertension on
Lj Pejcić1, I Jovanović, A Peco-Antić
1University Clinical Centre, Children's Hospital, Nisch.
Insights
Hypertension significantly impacts children on hemodialysis, causing increased left ventricular (LV) mass and hypertrophy. Echocardiography revealed lower ejection fraction and fractional shortening in these patients, highlighting risks associated with high blood pressure.
Area of Science:
- Cardiology
- Pediatric Nephrology
- Medical Imaging
Background:
- Hypertension is a common complication in children undergoing long-term hemodialysis.
- The effects of hypertension on cardiac structure and function in this pediatric population require thorough investigation.
Purpose of the Study:
- To evaluate the impact of hypertension on left ventricular (LV) anatomy and function in children on chronic hemodialysis.
- To identify echocardiographic parameters correlated with elevated blood pressure in pediatric hemodialysis patients.
Main Methods:
- Two-dimensional and M-mode echocardiography were utilized in children undergoing long-term hemodialysis.
- Key echocardiographic measurements included indexed left atrial diameter (LAi), LV diastolic diameter (LVDDi), interventricular septum (IVSi), posterior wall thickness (PWi), LV mass index (massi), ejection fraction (EF), fractional shortening (FS), velocity of circumferential fiber shortening (VCF), and wall stress (WS).
Main Results:
- Hypertensive children on hemodialysis exhibited significantly higher LAi, LVEDDi, IVSi, PWi, and massi compared to normotensive and healthy children.
- Both groups of dialyzed patients showed significantly lower EF and FS.
- LV mass index (massi), IVSi, and PWi demonstrated the strongest correlations with mean arterial pressure.
Conclusions:
- Hypertension is strongly associated with concentric left ventricular hypertrophy in pediatric patients on long-term hemodialysis.
- Echocardiographic assessment is crucial for detecting cardiac changes related to hypertension in this vulnerable group.
Abstract:
In order to evaluate the effects of hypertension on left ventricular (LV) anatomy and function, we investigated children on long-term hemodialysis using two-dimensional and M-mode echocardiography. The following echocardiographic estimations were made: indexed left atrial diameter (LAi) LV and diastolic diameter (LVDDi), inter ventricular septum (IVSi) and I.V posterior wall (PWi), with calculations of the LV mass index (massi), ejection fraction (EF), fractional shortening (FS), the velocity of circumferential fiber shortening (VCF) and wall stress (WS). LAi, LVEDDi, IVSi, PWi and massi were significantly higher in hypertensive patients than in normotensive and healthy children. EF and FS were significantly lower in both groups of dialyzed patients. The best correlation with mean arterial pressure had massi (r = 0.624), IVSi (r = 0.576) and PWi (r = 0.575). Those results suggest an important correlation between hypertension and concentric LV hypertrophy in long-term dialyzed patients.