Echocardiographic Hemodynamic Study during Ultrafiltration Sequential Dialysis

Cini, G; Camici, Marcella; Pentimone, F; Palla, Roberto

doi:10.1159/000182448

Cited by 18 publications

(5 citation statements)

References 18 publications

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“…The high incidence of cardiovascular complications in patients undergoing haemodialysis for chronic renal fail ure is well known [1][2][3][4], but the underlying role, if any, of cardiac arrhythmias remains to be determined. Published reports of disturbances of cardiac rhythm in these pa tients are conflicting [2,5].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Arrhythmias in Chronic Renal Failure?

Kyriakidis

Voudiclaris

Kremastinos

et al. 1984

Nephron

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25 patients undergoing regular haemodialysis for chronic renal failure underwent Holter ECG monitoring for a continuous 48-hour period covering dialysis and the intermediate period of everyday activity at home. A low dialysate potassium concentration (1.7 mEq/l) was used. Clinically significant arrhythmias ( > 100 ventricular extrasystoles/24 h) were found in only 1 patient and there were no complex ventricular arrhythmias. Benign atrial arrhythmias occurred in 22 patients (88%). Haemodialysis had no influence on type or frequency of arrhythmias.

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Section: Introductionmentioning

confidence: 99%

Cardiac Arrhythmias in Chronic Renal Failure?

Kyriakidis

Voudiclaris

Kremastinos

et al. 1984

Nephron

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“…In ourstudy, HRand TPR1 (afterload) were not different in the two groups. Myocardial contractility (mean Vcf and FS%) was normal in both groups [8,15]. Hemodialysis produces a decrease in plasma volume (end-dialysis mean body weight loss: 1.78 kg in group I; 2.0 kg in group II) and venous return with a secondary reduction in preload and in LV diastolic volume.…”

Section: Discussionmentioning

confidence: 94%

“…In chronic uremic patients many echocardiographic studies have been carried out to establish the presence of cardiac morphofunctional alterations [15,16]. In particu lar, some M-mode echocardiographic (MME) investiga tions have shown a significant incidence of asymmetric septal hypertrophy (ASH), but often the patients pre sented cardiomegaly [16][17][18][19] or arterial hypertension [17,18].…”

Section: Introductionmentioning

confidence: 99%

Asymmetric Septal Hypertrophy in Uremic-Normotensive Patients on Regular Hemodialysis

Bernardi¹,

Bernini²,

Cini³

et al. 1985

Nephron

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We have observed a high incidence (36.4%) of asymmetric septal hypertrophy (ASH), detected with the use of M-mode (MME) and two-dimensional echocardiography (2DE), in normotensive patients with chronic renal failure on maintenance hemodialysis without signs of cardiac diseases. ASH was detected by conventional MME in 11 cases and was confirmed with the use of 2DE in 8 cases showing a diagnostic concordance of 72.7% between the two methods. After dialysis the MME study of the left ventricular (LV) performance showed an evident impairment of cardiac index (CI) due to reduction of LV volume in addition to an abnormality of septal function. The presence of ASH does not impair the percentage of fractional shortening (FS%), the mean circumferential shortening (mean Vcf) and the ejection fraction (EF%), probably because of a compensatory performance of the LV posterior wall. Predialysis serum creatinine and fasting triglycerides have been found significantly higher in the group with ASH. ASH may be considered as a focal and early form of myocardial involvement in uremic patients on regular hemodialytic treatment.

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“…The hemodynamic response to isolated ultrafil tration in uremic patients is characterized by a constant blood pressure, an increased pe ripheral vasoconstriction and an unchanged heart rate [1][2][3][4][5]; if ultrafiltration is per formed at a very slow rate the vascular refill ing is complete and no hemodynamic changes occur [14], A remarkable constancy of the heart rate during isolated ultrafiltra tion [1][2][3][4], contrary to the findings during isovolemic hemodialysis with acetate as the buffer source [1,2,15], has been noted. This absence of heart rate increase in uremic pa tients has been suggested to be a sign of autonomous neuropathy [4]. However, the present results show that this is the circula tory response in healthy man as well.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Function and Arterial Blood Gases during Isolated Ultrafiltration in Healthy Man

Freyschuss¹,

Danielsson²,

Bergström³

1988

Blood Purif

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In order to recognize possible cardiovascular signs of underhydration during isolated ultrafiltration (IUF), we have studied the physiological hemodynamic adaptation to IUF in healthy man both above and below normohydration. In 7 subjects IUF was performed with the subjects in a normohydrated state at the start of IUF. In 8 subjects the IUF was preceded by a 1-hour infusion of Ringer solution equal to 3% of body weight. By invasive techniques, cardiac index (thermodilution), stroke index, heart rate, brachial and pulmonary arterial blood pressures, systemic vascular resistance index, central blood temperature, P_aO₂ and P_aCO₂ were measured. Calf vascular resistance was assessed by venous occlusion plethysmography. A recirculation period of 30 min was followed by IUF in both study groups. During IUF with overhydration and normohydration at the start of IUF, cardiac output fell because of a decline in stroke volume and an unchanged heart rate. Blood pressure remained constant because of systemic vascular constriction. P_aO₂ and P_aCO₂ remained unchanged. IUF in healthy man is mainly characterized by vascular constriction and an unchanged heart rate. Thus, the cardiovascular adaptation to ultrafiltration was the same whether or not ultrafiltration was performed at overhydration or normohydration at the start of ultrafiltration. Therefore, it is unlikely that monitoring of heart rate or noninvasive recording of blood pressure can predict whether a subject is becoming underhydrated during isolated ultrafiltration. The adaptation to IUF is similar to that observed during the treatment of uremic patients without complications.

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Echocardiographic Hemodynamic Study during Ultrafiltration Sequential Dialysis

Cited by 18 publications

References 18 publications

Cardiac Arrhythmias in Chronic Renal Failure?

Cardiac Arrhythmias in Chronic Renal Failure?

Asymmetric Septal Hypertrophy in Uremic-Normotensive Patients on Regular Hemodialysis

Cardiovascular Function and Arterial Blood Gases during Isolated Ultrafiltration in Healthy Man

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