Left Ventricular Mechanical Dispersion and Global Longitudinal Strain and Ventricular Arrhythmias in Predialysis and Dialysis Patients

Hensen, Liselotte C.R.; Goossens, Kathleen; Podlesnikar, Tomaž; Rotmans, Joris I.; Jukema, J. Wouter; Delgado, Victoria; Bax, Jeroen J.

doi:10.1016/j.echo.2018.01.010

Cited by 25 publications

(32 citation statements)

References 36 publications

(41 reference statements)

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“…Patients with end-stage kidney disease are observed to be at risk of serious arrhythmias. LV mechanical dispersion is proposed as a risk predictor of fatal arrhythmias in patients with chronic kidney disease (18). Thus, rapid ultrafiltration causing RV mechanical dispersion can have a possible arrhythmogenic influence that should be validated with further investigations.…”

Section: Discussionmentioning

confidence: 99%

Higher Ultrafiltration Rate is Associated with Right Ventricular Mechanical Dispersion

Ünlü¹,

Pagourelias

Sezenöz

et al. 2019

Anatol J Cardiol

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Higher ultrafiltration rate is associated with right ventricular mechanical dispersion Objective: Ultrafiltration rate is one of the major determinants of adverse outcomes in patients undergoing hemodialysis (HD) therapy. Previous studies have focused on the impact of HD on right ventricular (RV) peak strain values. However, the influence of HD on the temporal characteristics of deformation has not been reported yet. The aim of the present study was to evaluate the impact of high ultrafiltration rate (HUR) on RV mechanical dyssynchrony. Methods: Echocardiographic images focused on the RV and left ventricle (LV) were obtained from 60 patients (49.2±17.3 years, 22 female) before and after HD. Patients were divided into two groups according to ultrafiltration rate. Changes in echocardiographic parameters with HD were examined. Two-dimensional speckle-tracking strain analysis was used to assess deformation. Mechanical dispersion was measured as the standard deviation of time to peak longitudinal strain of six segments for RV and 18 segments for LV. Results: The average ultrafiltrated volume and ultrafiltration rate were 3000.1±1007.9 mL and 11.4±2.9 mL/kg/h, respectively. Global longitudinal strain (GLS) of the RV and LV decreased after HD in both groups. A significant difference was observed in RV mechanical dispersion with HD for patients in the high ultrafiltration group. A mild statistically insignificant increase in LV mechanical dispersion was also observed after HD. Conclusion: HUR has a substantial impact on LV and RV GLS and RV dyssynchrony. Ultrafiltration rates and volumes should be kept as low as possible to achieve hemodynamic stability and tolerability.

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Section: Discussionmentioning

confidence: 99%

Higher Ultrafiltration Rate is Associated with Right Ventricular Mechanical Dispersion

Ünlü¹,

Pagourelias

Sezenöz

et al. 2019

Anatol J Cardiol

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“…The 2018 report of Hensen et al 39 attempted to explore the relationship between dyssynchrony and mortality by retrospectively evaluating the incidence of ventricular arrhythmia in 250 predialysis and dialysis-dependent patients (CKD 3B-5). Interestingly, 16 of the 250 patients had ventricular arrhythmias (defined as aborted cardiac arrest, documented sustained ventricular tachycardia, or ventricular fibrillation) or sudden cardiac death.…”

Section: Pathophysiology Of Cardiac Fibrosis In Eskdmentioning

confidence: 99%

Cardiac Imaging in Dialysis Patients

et al. 2020

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There is a well-established yet unexplained high prevalence of cardiovascular morbidity and mortality in individuals with end-stage kidney disease receiving dialysis. Potential causes include changes in cardiac structure and function, with increased left ventricular mass index as the best established cardiac structural change associated with this increase in mortality. However, in recent years, new echocardiographic and cardiac magnetic resonance imaging techniques have emerged that may provide novel markers that may better explain the mechanisms underlying the cardiovascular morbidity and mortality observed in end-stage kidney disease. This review outlines advances in cardiac imaging and the current status of imaging modalities, including echocardiography, cardiac magnetic resonance imaging, and cardiac positron emission tomography, to identify dialysis patients at high risk for cardiovascular mortality.

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“…Another possible role of STE in advanced CKD has recently been postulated, with a hypothesis‐generating study showing that LV GLS and LV mechanical dispersion could identify the patients at risk for sudden cardiac death (SCD) due to mixture of scar and fibrous tissue within layers of viable myocardium, despite of relatively preserved LVEF . Both autopsy and CMR studies showed that LV GLS correlated well with increased extend of myocardial fibrosis .…”

Section: Speckle‐tracking Echocardiography (Ste)mentioning

confidence: 99%

Multi‐modality cardiac imaging in advanced chronic kidney disease

Ureche

Sascău

Țăpoi³

et al. 2019

Echocardiography

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Cardiovascular disease (CVD) is the leading cause of death worldwide and is particularly frequent among those with severe renal impairment. Early diagnosis and therapeutic intervention may help alleviate the burden of cardiovascular complication within this population. In the last years, advances have been made toward developing noninvasive imaging techniques that could offer better insight into the cardiac involvement in end‐stage renal disease (ESRD). Conventional transthoracic echocardiography remains the first‐line investigation used to assess cardiac function, but encompassing in our daily practice, the newer approaches such as speckle‐tracking imaging, cardiac computed tomography, or cardiac magnetic resonance can guide us to a more comprehensive understanding of CVD in ESRD. Given that patients with chronic kidney disease may not present with typical CVD symptoms, the amount of information brought by newer imaging techniques is crucial for an accurate diagnosis, risk stratification, and further management. The purpose of this review is to briefly summarize the specific applications of standard cardiac imaging techniques in patients with ESRD and to offer insight into the novel imaging modalities, highlighting the newest research in this field. By doing so, we aim to identify the most important imaging predictors of clinical outcomes in this population.

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Left Ventricular Mechanical Dispersion and Global Longitudinal Strain and Ventricular Arrhythmias in Predialysis and Dialysis Patients

Abstract: LV mechanical dispersion along with LV GLS may be an additional valuable risk marker of VA and SCD in predialysis and dialysis patients.

Cited by 25 publications

References 36 publications

Higher Ultrafiltration Rate is Associated with Right Ventricular Mechanical Dispersion

Higher Ultrafiltration Rate is Associated with Right Ventricular Mechanical Dispersion

Cardiac Imaging in Dialysis Patients

Multi‐modality cardiac imaging in advanced chronic kidney disease

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