Document Detail


A single session of haemodialysis improves left ventricular synchronicity in patients with end-stage renal disease: a pilot tissue synchronization imaging study.
MedLine Citation:
PMID:  18556749     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mechanical left ventricular (LV) dyssynchrony impairs cardiac function in patients with heart failure and LV hypertrophy (LVH) and may be a factor contributing to the high incidence of cardiac deaths in patients with end-stage renal disease (ESRD). Objectives. To evaluate the possible presence of LV dyssynchrony in ESRD patients, and acute effect of haemodialysis (HD) on LV synchronicity using a tailored echocardiographic modality, tissue synchronization imaging (TSI). METHODS: In 13 clinically stable ESRD patients (7 men; 65 +/- 10 years) with LVH, echocardiography data were acquired before and after a single HD session for subsequent off-line TSI analysis enabling the retrieval of regional intraventricular systolic delay data. Six basal and six midventricular LV segments were evaluated. Dyssynchrony was defined as a regional difference in time to peak systolic velocity >105 ms. RESULTS: Before HD, all patients had at least one dyssynchronous LV segment. The percentage of delayed segments correlated positively to LV end-diastolic diameter (r = 0.68, P < 0.05). HD induced a substantial decrease in the percentage of delayed segments from 36 +/- 25% to 19 +/- 14% (P < 0.01), reduced average maximal mechanical systolic LV delay from 300 +/- 89 to 225 +/- 116 ms (P < 0.05) and completely normalized LV synchronicity in three patients (23%). CONCLUSIONS: LV dyssynchrony appears to be present frequently in ESRD patients with LVH. The severity of LV dyssynchrony correlates with LV end-diastolic diameter and decreases after a single session of HD suggesting a mechanistic relevance of volume overload and possibly other toxins accumulating in HD patients.
Authors:
Shirley Yumi Hayashi; Astrid Seeberger; Britta Lind; Jacek Nowak; Marcelo Mazza do Nascimento; Bengt Lindholm; Lars-Ake Brodin
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-06-13
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  23     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-16     Completed Date:  2009-03-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  3622-8     Citation Subset:  IM    
Affiliation:
Department of Medical Engineering, School of Technology and Health, Royal Institute of Technology, Karolinska Institutet, Karolinska University Hospital in Huddinge, Stockholm, Sweden. shirley.yumi.hayashi@ki.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Echocardiography
Female
Heart Ventricles / physiopathology,  ultrasonography
Humans
Hypertrophy, Left Ventricular / etiology,  physiopathology*,  therapy*
Kidney Failure, Chronic / complications,  physiopathology*,  therapy*
Male
Middle Aged
Pilot Projects
Renal Dialysis*
Treatment Outcome
Ventricular Dysfunction, Left / etiology,  physiopathology*,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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