Echocardiographic parameters of the right ventricle in chronic hemodialysis.

INTRODUCTION: Right ventricular (RV) dysfunction is one of the leading predictors of mortality and heart failure in chronic hemodialysis (HD) patients. AIM: To describe the different echocardiographic abnormalities of the RV in subjects with HD. METHODS: We performed a descriptive cross-sectional study covering the period from July to October 2018; involving 42 patients treated with chronic HD. Patients underwent a conventional transthoracic echocardiographic (TTE) study supplemented with tissue Doppler between two hemodialysis sessions. RESULTS: We included 42 patients. The sex ratio of our population was 1.6 with a male predominance, the average age of patients was 62.7 ± 12.4 years. The most important cardiovascular risk factor was arterial hypertension (78.6%). The most important causative nephropathy was nephroangisclerosis (31% of cases). The average age of dialysis was 34.5±30 months. Forty-two percent of our patients had RV dilation, 38% had right atrium dilatation, 7% had Right ventricular outflow tract dilatation, and 59.5% had RV hypertrophy. We noted RV systolic dysfunction in 66.7% of cases, a predominant normalized tricuspid profile with an average E / A ratio of 1.11 ± 0.5. CONCLUSION: Our study is consistent with the various echocardiographic data already raised in the literature, showing a high prevalence of RV dilatation and systolic dysfunction. It is one of the leading predictors of mortality and heart failure in chronic hemodialysis patients.

[Epidemiologic aspects of cerebrovascular accidents in Tunisia]. / Aspects épidémiologiques des accidents vasculaires cérébraux en Tunisie.

We report the results of 3 epidemiological studies of stroke in Tunisia. In Tunis urban population, the crude annual incidence rate of stroke has been estimated at 0.54/1,000 and the prevalence rate at 6 to 14/1,000. The incidence rate adjusted to population at risk (greater than or equal to 45 years old), is around 1.92/1,000. A door-to-door survey conducted in Kelibia, according to a WHO protocol, showed a prevalence rate of 7.2/1,000 when adjusted to population at risk. CT diagnosed infarction and haemorrhage and excluded non-stroke cases (10 p. 100). Cerebral haemorrhage was more frequent than in other published studies (28 p. 100).