Impact of ahemodialysis session on cardiac function in patients withchronic renal failure

Abstract


Aim. To determine the impact of hemodialysis (HD) session on cardiac function in patients with
chronic renal failure.
Material and methods. Thirty patients (17 male, 13 female, mean age 49 ± 11 years) on bicarbonate
HD were studied. M-mode echocardiography was performed and ejection fraction (ЕЕ) was estimated.
Transmitral flow was assessed by Doppler echocardiography. Peak velocity of early (E) and late (A)
filling, E/A ratio, isovolumic relaxation time (IVRT) and early deceleration time (DT) were estimated.
All the estimations were made one hour before and immediately after HD by one investigator. Flow
propagation velocity of early diastolic flow was assessed by color M-mode Doppler echocardiography.
Results. A significant decrease of the ejection fraction (delta EF) was observed only in patients with
intradialytic hypotension. Hemodialysis resulted in a decrease of early flow velocity from 99.2 ± 23.8
to 80.6 ± 26.0 cm/s (p = 0.0000) and E/A ratio from 1.23 + 0.57 to 0.98 ± 0.43 (p = 0.006). IVRT
and DT showed no significant difference. There was a significant positive correlation between the
amount of ultrafiltration and deltaE (r = 0.46; p = 0.01), there was no correlation between the
amount of ultrafiltration and delta Vp (r = -0.01;p = 0.9).
Conclusion. The results show that a hemodialysis session influences cardiac function in patients with
chronic renal failure. Early diastolic filling considerably decreased in correlation with ultrafiltration. A
significant decrease in an ejection fraction was detected only in patients with intradialytic hypotension.
Ultrafiltration had no impact on flow propagation velocity of early diastolic flow of the left ventricle assessed by color M-mode Doppler echocardiography.

References

  1. Бикбов Б. Т., Томилина Н. А. О состоянии заместительной терапии больных с хронической почечной недостаточностью в Российской Федерации в 2000 г. (Отчет по данным Российского регистра). Нефрол. и диализ 2002; 3: 148- 170.
  2. Schreiber В. D. Congestive heart failure in patients with chronic kidney disease on dialysis. Am. J. Med. Sci. 2003; 325: 179- 193.
  3. Милованова Л. Ю., Николаев А. Ю., Сафронов В. В., Милованов Ю. С. Интрадиализная гипотония: ее причины и последствия. Тер. арх. 2003; 6: 50-53.
  4. Passauer J., Bussemaker Е., Gross P. Dialysis hypotension: Do we see light at the end of the tunnel? Nephrol. Dial. Transplant. 1998; 13: 3024-3029.
  5. Rouby J. J., Rottembourg J., Durande J. P. et al. Importance of the plasma refilling rate in genesis of hypovolaemic hypoten sion during regular dialysis and controlled sequential ultrafiltration haemodialysis. Proc. Eur. Dial. Transplant. Assoc. 1978; 14: 239-244.
  6. Prakash S., Reddan D., Heidenheim A. P. et al. Central, peripheral, and other blood volume changes during hemodialysis. ASAIO J. 2002; 48: 379-382.
  7. Cai Y., Zimmerman A., Ladefoged S., Secher N. H. Can haemodialysis-induced hypotension be predicted? Nephron 2002; 92: 582588.
  8. Sahn D. J., DeMaria A., Kissio J., Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circula- tion 1978; 58: 1072-1083.
  9. Schiller N. В., Shan P. M., Crawford M. et al. Recommenda tions for quantitation of the left ventricle by two-dimensional echocardiography. J. Am. Soc. Echocardiogr. 1989; 2: 358- 367.
  10. Рекомендации по диагностике и лечению хронической сердечной недостаточности. Доклад экспертной группы по диагностике и лечению хронической сердечной недостаточности Европейского общества кардиологов. Сердеч. недостат. 2001; 6: 251-276.
  11. И. Devereux R. В., Alomso D. R., Lutas E. M. et al. Echocardiographic assessment of left ventricular hypertrophy comparison to necropsy findings. Am. J. Cardiol. 1986; 57: 450-458.
  12. Abergel E., Tase M., Bohlader J. Which definition for echocardiographic left ventricular hypertrophy? Am. J. Cardiol. 1995; 75: 486-503.
  13. Ganau A., Devereux R. В., Roman M. J. et al. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J. Am. Coll. Cardiol. 1992; 19: 1550-1558
  14. . European Study Group on Diastolic Heart Failure. How to diagnose diastolic heart failure. Eur. Heart J. 1998; 19: 990- 1003.
  15. Garcia J. M., Ares A. M., Asher С et al. An index of early left ventricular filling that combined with pulsed Doppler peak E velocity may estimate capillary wedge pressure. J. Am. Coll. Cardiol. 1997; 29: 448-454.
  16. Andrulli S., Colrani S., Mascia F. et al. The role of blood volume reduction in the genesis of intradialytic hypotension. Am.J. Kidney Dis. 2002; 40: 1244-1254.
  17. Krepel H. P., Nette R. W., Akcahuseyin E. et al. Variability of relative blood during haemodialysis. Nephrol. Dial. Transplant. 2000; 15: 673-679.
  18. Шутов А. M., Мастыков В. Э., Едигарова О. М. Диастолическая дисфункция и интрадиализная гипотензия. Нефрол. и диализ 2003; 2: 156-160.
  19. McGregor D. О., Buttimore A. L., Lynn К. L. et al. A comparative study of blood pressure control with shot in-center versus long home hemodialysis. Blood Purif. 2001; 19: 293-300.
  20. Robinson T. G., Can S. J. Cardiovascular autonomic dysfunction in uremia. Kidney Int. 2002; 62: 1921-1932.
  21. Garcia M. J., Smedira N. G., Greenberg N. L. et al. Color Mmode Doppler flow propagation velocity is a preload insensi-tive index of left ventricular relaxation: Animal and human validation. J. Am. Coll. Cardiol. 2000; 35: 201-208.
  22. Moller J. E., Sbndergaard E., Sevard J. B. et al. Ratio of left ventricular peak E-wave velocity to flow propagation velocity assessed by color M-mode Doppler echocardiography in first myocardial infarction. J. Am. Coll. Cardiol. 2000; 35: 363- 370.
  23. Stugaard M., Smiseth O. A., Risoe C, Men H. Intraventricular early diastolic filling during acute myocardial ischemia: assess ment by multigated color M-mode Doppler. Circulation 1993; 88: 2705-2713.
  24. Garcia M., Palac R., Malenka D. et al. Color M-mode flow propagation velocity is a relatively preload-independent index of left ventricular filling. J. Am. Soc. Echocardiogr. 1999; 12: 129-137. /
  25. e E. H., Vletter W. В., ten Gate F. J. et al. Preload dependence of new Doppler techniques limits their utility for left ventricular diastolic function assessment in hemodialysis patients.J. Am. Soc. Nephrol. 2003; 14: 1858-1862.
  26. Graham R. J., Gelman J. S., Donelan L. et al. Effect of preload reduction by haemodialysis on new indices of diastolic function. Clin. Sci. 2003; 105: 499-506.
  27. Chamoun A. J., Xie Т., Trough M. et al. Color M-mode flow propagation velocity versus conventional Doppler indices in the assessment of diastolic left ventricular function in patients on chronic hemodialysis. Echocardiography 2002; 19: 467- 474.
  28. Vierendeels J. A., Dick E., Verdonck P. R. Hydrodynamics of color Mmode Doppler flow wave propagation velocity V(p): a computer study. J. Am. Soc. Echocardiogr. 2002; 15: 219- 224.

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