Aim

Cardiovascular mortality is high in patients with end stage renal disease (ESRD) on hemodialysis (HD). In addition, HD per se can stress cardiac function because of the acute hemodynamic changes in blood volume, arterial pressure, electrolytes and sympatho-vagal balance. Doppler Tissue Imaging (DTI) is a method which allows noninvasive assessment of both left (LV) and right ventricular (RV) function. The aim was to evaluate the effect of hemodialysis (HD) on LV and RV function by DTI.

Method

Thirty patients (18 males, aged 45 ± 15 years) with ESRD on maintenance HD (for 30 ± 26 months) were recruited from the Dialysis Unit of our institution. The group included 30 patients on HD (45 ± 15 years). Myocardial (Sm, Em, Am) and annular velocities (Ea, Aa) were measured before and after HD.

Method

Thirty patients (18 males, aged 45 ± 15 years) with ESRD on maintenance HD (for 30 ± 26 months) were recruited from the Dialysis Unit of our institution. The group included 30 patients on HD (45 ± 15 years). Myocardial (Sm, Em, Am) and annular velocities (Ea, Aa) were measured before and after HD.

Results

After HD, Ea significantly reduced (p = 0.029). Patients exhibited a lower Em (p = 0.026 for lateral wall, p < 0.0001 for septum, p = 0.002 for inferior wall, p = 0.009 for anterior wall) and a reduced Em/Am ratio (p = 0.01 for lateral wall, p < 0.0001 for septum and inferior wall, p = 0.016 for anterior wall) of all LV walls (table 1).

At the RV segments, Sm (p = 0.016 for apical segment, p < 0.0001 for mid segment, p = 0.003 for basal segment), Em (p = 0.001 for apical segment, p < 0.0001 for mid and basal segment), and Am (p = 0.016 for apical segment, p = 0.001 for mid segment, p < 0.0001 for basal segment) decreased significantly (table 2).

Em of the anterior wall was positively related to ultrafiltration volume (r = 0.25, p = 0.006), whereas the decrease of Sm of RV basal segment correlated with a decrease of diastolic blood pressure (r = 0.23, p < 0.01).