Effect of maintenance hemodialysis on diastolic left ventricular function in end-stage renal disease

Abstract

PURPOSE:To analyze the effect of maintenance hemodialysis on left ventricular diastolic function in patients with end-stage renal disease.METHODS: Study population consisted of 42 patients with end-stage renal disease. Before an arteriovenous fistula was surgically created, the patients were evaluated by conventional and Doppler echocardiography and Doppler tissue imaging. Then, the patients undergoing hemodialysis treatment when the arteriovenous fistula was compleated. After the first hemodialysis session (mean 76.14 ¡ 11.37 days) the second echocardiographic evaluations were performed. RESULTS:Mean age was 58 ¡ 13 years and 21 (%50) of the patients were female. After maintenance hemodialysis treatment; peak early (E) and peak late (A) diastolic mitral inflow velocities and E/A ratio were not significantly change however the deceleration time of E wave and left atrial diameter were significantly increased. Also there was no change in the early (Em) and late (Am) diastolic myocardial velocities and Em/Am ratios of lateral and septal walls of left ventricular. E/Em ratio was decreased insignificantly. Pulmonary vein velocities and right ventricular functions are remained almost unchanged after hemodialysis treatment.

Cardiology in Brazilian scientific journals: an overview

“…Two articles cover the Renal/Cardiological interaction: Duran et al [46] analyzed the effect of maintenance hemodialysis on left ventricular diastolic function in 42 patients with end-stage renal disease and found that disease treatment in these patients with hemodialysis via arteriovenous fistulae induce a variety of hemodynamic and metabolic abnormalities that predispose to alterations in left and right ventricular functions. They claim that left ventricular diastolic function and right ventricular functions were not significantly changed, but that left ventricular systolic functions were impaired after maintenance hemodialysis treatment in these patients.…”

Comparison of the Effects of Dialysis Methods (Haemodialysis vs Peritoneal Dialysis) on Diastolic Left Ventricular Function Dialysis methods and diastolic function

“…They demonstrated that in the long run, the acute changes of volume, electrolytes and autonomic regulation due to haemodialysis session does not affected left diastolic function. [16] For Lee et al, the prevalence and severity of diastolic LV dysfunction is higher in PD patients [17].…”

Diastolic dysfunction in end-stage renal disease patient: what the ticking clock has told us?

“…The inability to detect LV and even right ventricular function change in the study by Duran et al1 may have also been the result (to a lesser degree) of a decreased severity of the LVH in their patient population, which may reflect the lower frequency of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use. The pre-dialysis blood pressure of their patients was also better controlled (average systolic/diastolic 135/83 mmHg), possibly attenuating an otherwise detectable LV change.…”

“…The results of these studies support the importance of the duration of the follow-up period when identifying myocardial remodeling in end stage renal disease patients undergoing hemodialysis. As the median duration of the follow-up period in Duran's study was approximately 2 months,1 the myocardial change is expectedly small, notwithstanding the possibility of a more subtle change in diastolic dysfunction even without an increasing LV mass 2. …”

“…I read with interest the article titled “Effect of maintenance hemodialysis on diastolic left ventricular function in end-stage renal disease” by Duran et al1 in the October 2010 issue of this Journal and would like to present some comments on this article. The authors conducted an intriguing study to determine whether a change in cardiac function occurs after commencing hemodialysis with arteriovenous fistula.…”