Left and right ventricular diastolic function in hemodialysis patients.

The aim of this prospective study was the assessment of left ventricular and right ventricular diastolic function in patients on hemodialysis (HD) and the correlation of this function with the duration of HD. The study included 42 patients (22 females and 20 males) with chronic renal failure (CRF), treated with HD, and 40 healthy subjects (24 females and 16 males) with no history of cardiovascular disease and with normal renal function, who constituted the control group. The groups were matched for age and sex. All study patients and control subjects underwent detailed history taking and physical examination. They also underwent electrocardiogram, echocardiography and biochemical and hematological blood analyses. Significant differences were noted between the two groups in the two-dimensional and M-mode echocardiography findings concerning aortic root dimension, transverse diameter of the left atrium, thickness of the interventricular septum, thickness of the left ventricular posterior wall, left ventricular diastolic diameter, left ventricular systolic diameter, shortening fraction, ejection fraction as well as findings from the pulse Doppler study, including E wave, A wave, E/A ratio, deceleration time of E wave (DT-E), acceleration time of E wave (AT-E), tricuspid E and A waves (E tr and A tr ) and E tr /A tr , ratio. There were significant changes in HD patients without arterial hypertension as well in the control group subjects. Our study suggests that the left ventricular and left atrial dimensions as well as the left ventricular wall thickness are augmented in patients with CRF treated with HD compared with the control group. Additionally, the left and right ventricular diastolic function is also reduced in these patients. These differences were also noted in patients with CRF without arterial hypertension. Left ventricular diastolic dysfunction had no correlation with the duration of HD.

Echocardiographic assessment of left atrial size in patients with end-stage renal disease.

BACKGROUND: Cardiac disease is the most common cause of death in patients with end-stage renal disease. It is assumed that the high rate of cardiovascular mortality is related to accelerated atherosclerosis. Patients with chronic renal insufficiency have an increased prevalence of coronary artery disease, silent myocardial ischaemia, complex ventricular arrhythmias, atrial fibrillation, left ventricular hypertrophy, annular mitral and aortic valve calcification, and enlargement of the left atrium, than patients with normal renal function. It is also well known that haemodialysis is associated with cardiovascular structural changes and rapid fluctuations in electrolyte levels. In this study, we sought to estimate left atrial size by means of echocardiography and to determine any correlations between different echocardiographic measurements in patients with end-stage renal disease. METHODS: We analysed data from 123 patients who were on regular haemodialysis, by means of traditional transthoracic echocardiographic examination. The usual statistical parameters, correlations and the Student's t-test were performed, with levels of significance of p < 0.01 and p < 0.05. RESULTS: The most presented age group was 60 to 69 years old, with a predomination of females (56.1%). We found dilated left atrium in 26.02% of the study patients and a high statistical correlation between different methods of measurement and calculated volumes of the left atrium. CONCLUSION: Evaluation of left atrial size should be determined by several different measurements, and left atrial enlargement should be seen as a risk factor for advancing disease.