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Yeungnam Univ J Med > Volume 16(2); 1999 > Article
Yeungnam University Journal of Medicine 1999;16(2):309-317.
DOI: https://doi.org/10.12701/yujm.1999.16.2.309    Published online December 31, 1999.
Impact of Hemodialysis on Left Ventricular Performance: A Doppler Echocardiographic Study.
Dong Oh Kang, Du Ha Lee, Hyun Seo Kim, Hyun Su Kim, Sung Rok Kim, Jong Seon Park
1Department of Internal Medicine, Masan Samsung Hospital College of Medicine, Sungkyunkwan University, Masan, Korea.
2Department of Internal Medicine College of Medicine, Yeungnam University, Taegu, Korea.
Abstract
BACKGROUND: Left ventricular diastolic filling is an important determinant for maintenance of cardiac output during hemodialysis. Few investigators have studied the influence of hemodialysis on diastolic function. To evaluate the change of left ventricular systolic and diastolic function, we performed M-mode and Doppler echocardiopraphic studies before and after hemodialysis. METHODS: The study population consisted of 30 patients(15 patients were male, mean age 45+/-10 years) with CRF on maintenance henodialysis. They have normal left ventricular systolic function(Fractional shortening > 30%) and no evidence of valvular heart disease or regional wall motion abnormalities. The ejection fraction(EF) was measured using M-mode echocardiography and Doppler indices such as peak E velocity, peak A velocity, isovolumetric relaxaion time(IVRT), deceleration time(DT), and left ventricular ejection time(LVET) obtained from Doppler echocardiography. The index of myocardial performance(IMP) was calculated from each of the Doppler velocity indices. RESULTS: The weight reduction after hemodialysis was 2.1+/-1.0kg(p<0.0001). After hemodialysiss, there was some decrease in blood pressure(p<0.05), but no significant change in heart rate, EF and fractional shortening, mean VCF, peak A velocity, and DT. And significant in IVRT and IMP(p<0.05, p<0.0001) were noted. CONCLUSTION: In conclusion, preload reduction is the main mechanism that accounts for changes in Doppler diastolic indices after hemodialysis. And and increased IMP suggests that diastolic function may be aggravated after gemodialysis, and that implies impaired left ventricular filling and disturbed left ventricular compliance.
Key Words: Diastolic left ventricular function, Hemodialysis, Doppler echocardiography
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