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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE Table of Contents   
Year : 2014  |  Volume : 25  |  Issue : 4  |  Page : 756-761
Acute hemodialysis effects on doppler echocardiographic indices


1 Cardiology Department, University Hedi Chaker Hospital, Medicine University of Sfax, Tunisia
2 Nephrology Department, University Hedi Chaker Hospital, Sfax, Tunisia

Correspondence Address:
Leila Abid
Cardiology Department, University Hedi Chaker Hospital, Medicine University of Sfax, Sfax
Tunisia
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DOI: 10.4103/1319-2442.134982

PMID: 24969184

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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 81chronic 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 cm [3] . HD led to reduction in LV end-diastolic volume (P <0.001), end-systolic volume (P <0.001), left atrium area (P <0.001), peak early (E-wave) trans-mitral flow velocity (P <0.001), the ratio of early to late Doppler velocities of diastolic mitral inflow (P <0.001) and aortic time velocity integral (P <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 <0.001 and P <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 pre­load reduction in HD patients.


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