ISSN:
1437-7799
Keywords:
Key words Acute preload reduction
;
Doppler echocardiography
;
Left ventricular diastolic function
;
Maintenence hemodialysis
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background. Our objective was to investigate changes in left ventricular inflow jet width and long axis motion in patients on maintenance hemodialysis by preload reduction due to a single hemodialysis. Methods. We evaluated 20 patients on stable maintenance hemodialysis by Doppler echocardiography. Twenty age-matched controls were also examined. Transmitral flow, left ventricular long axis M-mode (LAM) echocardiography, and two-dimensional color Doppler early diastolic left ventricular inflow jet width (JW) were analyzed before and after a single hemodialysis. Results. Before hemodialysis, compared with controls, JW was reduced in patients (2.1 ± 0.4 vs 2.4 ± 0.3 cm; P 〈 0.01), and early diastolic excursion of LAM (LAM-E) was also reduced. Peak velocity of the Doppler transmitral early diastolic wave (E) and late diastolic wave (A) were both higher, while the E/A ratio was lower. After hemodialysis, compared with the predialysis findings, JW and early diastolic excursion of LAM were unchanged; however, Doppler transmitral flow showed decreased E and E/A. Thus, in hemodialysis patients, inflow jet width was narrow, and unchanged by a single hemodialysis, while the Doppler transmitral flow pattern was changed mainly to dominant A waves and reduced E waves. Conclusions. In patients on maintenance hemodialysis, the abnormal left ventricular inflow jet dynamics and early diastolic incoordinate long axis motion are unmasked by a preload reduction due to single hemodialysis in a different way from a transmitral Doppler flow pattern.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s101570050034
