Author/Authors :
Abid, Leila Medicine University of Sfax - University Hedi Chaker Hospital - Cardiology Department, Tunisia , Rekik, Hajer Medicine University of Sfax - University Hedi Chaker Hospital - Cardiology Department, Tunisia , Jarraya, Fayçal University Hedi Chaker Hospital - Nephrology Department, Tunisia , Kharrat, Ilyes Medicine University of Sfax - University Hedi Chaker Hospital - Cardiology Department, Tunisia , Hachicha, Jamil University Hedi Chaker Hospital - Nephrology Department, Tunisia , Kammoun, Samir University Hedi Chaker Hospital - Nephrology Department, Tunisia
Abstract :
Conventional echocardiographic (ECHO) parameters of systolic and diastolic function of the left ventricular (LV) have been shown to be load dependent. However,the impact of pre-load reduction on tissue Doppler (TD) parameters of LV function is incompletely understood. To evaluate the effect of a single hemodialysis (HD) session on LV systolic and diastolic function using pulsed Doppler echocardiography and pulsed tissue Doppler imaging (TDI),we studied 81 chronic HD patients (40 males; mean age 52.4 ± 16.4 years) with these tools. ECHO parameters were obtained 30 min before and 30 min after HD. Fluid volume removed by HD was 1640 ± 730 cm3. HD led to reduction in LV end-diastolic volume (P lt;0.001),end-systolic volume (P lt;0.001),left atrium area (P lt;0.001),peak early (E-wave) trans-mitral flow velocity (P lt;0.001),the ratio of early to late Doppler velocities of diastolic mitral inflow (P lt;0.001) and aortic time velocity integral (P lt;0.001). No significant change in peak S velocity of pulmonary vein flow after HD was noted. Early and late diastolic (E ) TDI velocities and the ratio of early to late TDI diastolic velocities (E /A ) on the lateral side of the mitral annulus decreased significantly after HD (P = 0.013; P = 0.007 and P = 0.008,respectively). Velocity of flow progression (Vp) during diastole was not affected by pre-load reduction. Pulmonary artery systolic pressure and the diameter of the inferior vena cava decreased significantly (P lt;0.001 and P lt;0.001,respectively) after HD. We conclude that most of the Doppler-derived indices of diastolic function are pre-load-dependent and velocity of flow progression was minimally affected by pre-load reduction in HD patients.
