TO EVALUATE THE CHANGE IN LEFT VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTION AFTER DIALYSIS IN PATIENTS WITH CYCLIC HEMODIALYSIS

Thái Bảo Trịnh 1,, Hữu Dũng Nguyễn2, Kim Bảng Đỗ 3
1 Medical Center of Que Vo District, Bac Ninh Province
2 Bach Mai hospital
3 Vietnam national heart institute

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Abstract

Objective: Hemodialysis can affect the hemodynamics and cardiac function of patients with cyclic hemodialysis. Our study aimed to evaluate the change in left ventricular systolic and diastolic function after dialysis in patients with cyclic hemodialysis at Bach Mai Hospital. Subjects and methods: A cross-sectional descriptive study. There were 61 patients with cyclic hemodialysis (n=61) includes in the study. All patients participating in the study were asked about their disease, clinical examination, and echocardiography before and after dialysis. Results: The average age of the study subjects was 51,5 ± 12,2 years old, of which 31 men accounted for 50,8 %. After dialysis, there was a significant decrease in left ventricular end-systolic volume (Vs, 41,7 ± 23,3 ml vs 36,4 ± 21,1ml, p < 0,05) and left ventricular end-diastolic volume (Vd, 118,7 ± 31,3 ml vs 111.0 ± 31.4 ml, p < 0,05), left ventricular ejection fraction was not significantly improved. E wave velocity (89,9 ± 24,1 vs 71,9 ± 24,4 m/s) decreased statistically significantly compared to pre-dialysis with p< 0.0001. Meanwhile, the A wave velocity (96.3 ± 29.0 vs 96.2 ± 29.7 m/s) change insignificantly and there was almost no statistical difference between before and after dialysis with p > 0,05. E/A ratio (1.01 ± 0.4 vs 0.82 ± 0.45, p < 0,05) and mean E/e’ ratio (12.4 ± 4.7 vs 10.6 ± 4,3, p < 0,0001) significantly decreased after dialysis. The flow velocity through the tricuspid valve did not change significantly after dialysis (VmaxTR, 2.5 ± 0.4 vs 2.4 ± 0.4 m/s, p> 0,05). After dialysis, the left atrial volume index decreased significantly compared with before dialysis (LAVi, 42.8 ± 14.8 vs 36.5 ± 14.3 ml/m2) with p < 0,0001. Conclusion: Echocardiographic assessment of left ventricular systolic and diastolic function had a statistically significant improvement between before and after dialysis. This difference is related to the volume of hemodialysis during that dialysis session.

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References

1. Streja E, Norris KC, Budoff MJ, Hashemi L, Akbilgic O, Kalantar-Zadeh K. 2021. The quest for cardiovascular disease risk prediction models in patients with nondialysis chronic kidney disease. Curr Opin Nephrol Hypertens;30(1):38-46.
2. Tsilonis K, Sarafidis PA, Kamperidis V, et al. 2016. Echocardiographic Parameters During Long and Short Interdialytic Intervals in Hemodialysis Patients. Am J Kidney Dis;68(5):772-781.
3. Mitchell C, Rahko PS, Blauwet LA, et al. 2019. Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr;32(1):1-64.
4. Drighil A, Madias JE, Mathewson JW, et al. 2008. Haemodialysis: effects of acute decrease in preload on tissue Doppler imaging indices of systolic and diastolic function of the left and right ventricles. Eur J Echocardiogr;9(4):530-535.
5. Ibrahim S, Koura M, Emara A, Kamel M, El-Wahed WagdyAA. 2016. The effect of hemodialysis-induced preload changes on the left ventricular function: a speckle-tracking echocardiographic study. Menoufia Med J;29(2):406.
6. Charfeddine S, Abid L, Hammami R, Bahloul A, Triki F, Kammoun S. 2021. Left ventricular myocardial function in hemodialysis patients: the effects of preload decrease in conventional, Doppler and speckle tracking echocardiography parameters. Pan Afr Med J;38.
7. Dincer I, Kumbasar D, Sayin T. 2002. Assessment of left ventricular diastolic function with Doppler tissue imaging: Effects of preload and place of measurements. The International Journal of Cardiovascular Imaging; 18: 155–160.
8. Agmon Y, Oh JK, McCarthy JT, Khandheria BK, Bailey KR, Seward JB. 2000. Effect of volume reduction on mitral annular diastolic velocities in hemodialysis patients. Am J Cardiol; 85(5):665-668.
9. Wang X, Hong J, Zhang T, Xu D. 2021. Changes in left ventricular and atrial mechanics and function after dialysis in patients with end-stage renal disease. Quant Imaging Med Surg;11(5):1899-1908.
10. Assa S, Hummel YM, Voors AA, et al. 2013. Changes in Left Ventricular Diastolic Function During Hemodialysis Sessions. Am J Kidney Dis;62(3):549-556.