Impact of dialysis modality on the appropriateness of left ventricular mass in patients with end-stage renal disease

Pathophysiology of biventricular dysfunction during hemodialysis: Emerging concepts

“…Indeed LV dysfunction, identified by stress-corrected midwall shortening, was largely increased in HD patients compared to PD group and healthy controls. We also found that metabolic abnormalities and systemic inflammation were more frequent among HD patients as compared to PD group [19]. These factors significantly correlated with ILVM and may explain, at least in part, the increased prevalence of ILVM and LV dysfunction in HD patients (Fig.…”

“…ILVM has been attributed to an increase in body size, adverse metabolic profile or to the presence of myocardial fibrosis as a consequence of different stimuli such as hyperactivation of the reninangiotensin-aldosterone system, growth factors, inflammation or chronic myocardial ischemia [16,18]. We reported that among dialysis patients, those undergoing HD displayed an increased prevalence of ILVM and this finding was strongly associated with lower myocardial function as well as reduced afterload-independent LV systolic chamber function [19]. Indeed LV dysfunction, identified by stress-corrected midwall shortening, was largely increased in HD patients compared to PD group and healthy controls.…”

Relation between right and left ventricular function in patients undergoing chronic dialysis

“…Systolic myocardial velocity (S m ), early (E m ) and late (A m ) peak diastolic myocardial velocities as well as E/E m ratio, an index of ventricular filling pressure, were calculated. 9 Ejection time, isovolumic relaxation time (IVRT) and isovolumic contraction time were also calculated by using TDI-derive intervals. 3,9 Myocardial performance index (MPI) of the left ventricle (LV MPI) was calculated as previously described.…”

“…9 Ejection time, isovolumic relaxation time (IVRT) and isovolumic contraction time were also calculated by using TDI-derive intervals. 3,9 Myocardial performance index (MPI) of the left ventricle (LV MPI) was calculated as previously described. 15 Subclinical LVD was defined by a value of LV MPI more than two standard deviations (2SD) from the mean value derived from 100 healthy individuals (MPI > 0.63 identified subtle systolic dysfunction in the study population).…”

“…Indeed, volume overload, uraemia, inflammation and myocardial ischaemia are determinants of LVD in this setting. 8,9 In the present study, we investigate the independent contribution of RVD on indices of left ventricular function in a relatively large cohort of dialysis patients without overt cardiovascular disease and with preserved left ventricular ejection fraction (LVEF).…”