Haemodialysis: effects of acute decrease in preload on tissue Doppler imaging indices of systolic and diastolic function of the left and right ventricles

Abstract

This study shows that both systolic and diastolic TDI velocities of the LV and RV are preload-dependent. However, the lateral mitral annulus is more resistant to preload changes than either the septal mitral annulus or the lateral tricuspid annulus.

Non Invasive Evaluation of Cardiac Hemodynamics in End Stage Renal Disease (ESRD)

“…Our data are confirmatory in detecting preload sensitiveness of not only transmitral flow Doppler [7,19] but of main tissue Doppler parameters as well [9,20]. Inferior vena cava diameters as expected were significantly modified by dehydration, accordingly to previous studies [17,20,21].…”

Acute Haemodialysis-induced Changes in Tissue Doppler Echocardiography Parameters

“…Mendes et al (17) reported that pulsed TDI, colour TDI, and speckle tracking imaging provided similar outcomes for the calculation of S and D myocardial operation in clinically stable patients with ESRD on HD for more than 4 months. Interestingly, Drighil and colleagues (11) suggested that systolic and diastolic venticular TDI velocities are load-dependent, and that potent HD treatment may provide insight into determining the onset of diastolic dysfunction in adolescent ESRD patients. Additionally, Fijalkowski et al (14) suggested that mitral annular TDI velocity may offer an optional worthwhile preload-independent marker for evaluating LV D impairment in ESRD.…”

“…Because of this, the frequency and severity of LV dysfunction may be grossly underestimated. Therefore, parameters with low sensitivity to loading conditions (load-independent) are clinically relevant (11,16,17). Our current findings suggest that the Em/Am ratio determined from HD patients using TDI may serve as a relatively loadindependent predictor of diastolic function.…”

“…For ethical reasons, we did not keep the total fluid volume removed constant, so the quantity of dialytic fluid removed was not controlled. Finally, in compliance with previous studies (11,17), the ECHO and TDI variables were given for the pre-or post-HD conditions. Our future research will be aimed at clarifying whether these changes in the ECHO and TDI parameters have prognostic implications for HD patients.…”

“…The use of newer Doppler techniques that can examine cardiac function independent of volume status, such as tissue Doppler imaging (TDI), may prove useful for early diagnosis (12, 13). TDI can adequately measure relaxation and contraction velocities from the myocardium and has been recommended as quantitative and relatively load-independent (11,14). Throughout HD treatment, the intravascular volume of these patients is reduced a plausible group to investigate the role of acute preload Background: Tissue Doppler imaging (TDI) is a method that determines the tissue motion and velocity within the myocardium.…”