Abstract 14700: Impact of Hemodialysis on Left Ventricular Systolic and Diastolic Properties Before and After Dialysis: a Three-dimensional Speckle Tracking Echocardiography Study
Introduction: Most patients with dialysis have left ventricular (LV) hypertrophy and fibrosis which may result in heart failure. Although estimation of LV function and fluid status is helpful in treatment of dialysis patients, noninvasive evaluation of LV function has not been fully performed.
Hypothesis: We sought to evaluate LV systolic and diastolic properties in dialysis patients by 3-dimensional speckle tracking echocardiography (3D-STE) just before and after dialysis.
Methods: Left atrial and LV function were measured in 64 patients with dialysis (age; 63±13, 27 men) and 40 controls (age; 65±7, 20 men) by 3D-STE. Pulmonary capillary wedge pressure (ePCWP) was estimated as 10.8 - 12.4 x log (LA active emptying function / min. LAV). Isovolumic relaxation (IVR) time was obtained by Doppler echo. Time constant of LV pressure decline (Tau) as index of relaxation was estimated as IVR time / (ln 0.9 x systolic blood pressure - ln ePCWP). LV stiffness was estimated by diastolic stress / strain. LV stress was calculated as pressure x dimension / thickness.
Results: There was no significant difference in LVEF between dialysis patients and controls (62±6 vs 63±8%). Systolic BP was decreased from 147±21 to 135±24mmHg after dialysis. LVEF and strain in dialysis patients were improved after dialysis associated with decreased systolic stress (Table). Tau was prolonged and stiffness was increased in dialysis patients compared to control (45±5 vs 31±9msec and 0.59±0.27 vs 0.26±0.10, respectively) and those were improved after dialysis associated with decreased diastolic stress but still higher than normal. ePCWP and E/e’ in dialysis patients were higher than normal (11.8±2.5 vs 6.8±2.5mmHg and 16.1±5.7 vs 9.4±2.8, respectively) and decreased after dialysis.
Conclusions: LVEF and strain in dialysis patients were increased and LV relaxation and stiffness were improved after dialysis. LV function in dialysis patients may be noninvasively and comprehensively evaluated by 3D-STE.
Author Disclosures: M. Kawasaki: None. R. Tanaka: None. H. Sato: None. S. Minatoguchi: None. T. Kariya: None. T. Yoshizane: None. K. Ono: None. T. Noda: None. K. Nagata: None. S. Sawada: None. K. Goto: None. H. Ohashi: None. S. Minatoguchi: None.
- © 2016 by American Heart Association, Inc.