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Changes in left ventricular filling parameters before and after dialysis in patients with end stage renal disease

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  1. Kidney function and the prognostic value of myocardial performance index

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  2. The prognostic value of left atrial dyssynchrony measured by speckle tracking echocardiography in the general population

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  1. Antibody-dependent neutralizing capacity of the SARS-CoV-2 vaccine BNT162b2 with and without previous COVID-19 priming

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  2. Capsid-like particles decorated with the SARS-CoV-2 receptor-binding domain elicit strong virus neutralization activity

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  3. Lifetime Risk of Heart Failure and Trends in Incidence Rates Among Individuals With Type 2 Diabetes Between 1995 and 2018

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  4. Hemodynamic Determinants of Activity Measured by Accelerometer in Patients With Stable Heart Failure

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The aim of this study was to investigate the grading of diastolic dysfunction (DD) in relation to hemodialysis in patients with end stage renal disease (ESRD) on hemodialysis (HD) Cardiovascular disease is prevalent in patients with ESRD and accounts for significant morbidity and mortality. Left ventricular hypertrophy (LVH) is common in ESRD but little is known about the impact of HD on currently recommended grading schemes for DD. Comprehensive echocardiographic data was obtained in consecutive patients with ESRD before (n = 247) and immediately after (n = 239) standard HD regimen. Grading of DD was performed according to current recommendations both pre- and post HD. Prior to HD, DD was classified as present in 83 patients (34%), indeterminate in 51 patients (21%) and absent in 113 patients (45%). Patients with DD at baseline compared to those without were older [67.3 years (13.1) vs. 63.2 (14.3), p = 0.037], were more likely to have diabetic- or hypertensive ESRD (43.4% vs. 35.4%, p = ns) and LVMi was significantly higher [119 g/cm 2 (27.5) vs. 103 g/cm 2 (24.3), p < 0.001]. After HD [mean HD time = 221 min (27.6), mean ultrafiltration volume = 2 L (1.1)], 39 patients (16%) exhibited sustained DD. These patients were older [69.4 years (14.5) vs. 65.0 years (13.9), p = 0.071], were more likely to have diabetic- or hypertensive ESRD (59% vs. 36%, p = 0.010). Myocardial adverse remodeling was more advanced with higher LVMi [127.4 g/m 2 (27.5) vs. 106.5 g/m 2 (25.3), p < 0.001], lower LVEF [44.7% (11.0) vs. 54.5% (8.7), p < 0.001] and more impaired GLS [− 13.4% (4.3) vs. − 15.8% (4.0), p = 0.006]. Echocardiographic evaluation of diastolic function in patients with ESRD on HD is critically dependent on timing relative to dialysis. The presence of sustained DD after volume unloading by HD identifies a population of patients with an adverse phenotype of blunted vascular response and severe cardiac remodeling.

Original languageEnglish
JournalThe international journal of cardiovascular imaging
Volume35
Issue number9
Pages (from-to)1673-1681
Number of pages9
ISSN1569-5794
DOIs
Publication statusPublished - Sep 2019

    Research areas

  • Aged, Diastole, Echocardiography, Doppler, Color, Echocardiography, Doppler, Pulsed, Female, Humans, Hypertrophy, Left Ventricular/diagnostic imaging, Kidney Failure, Chronic/diagnosis, Kidney/physiopathology, Male, Middle Aged, Predictive Value of Tests, Renal Dialysis, Risk Factors, Severity of Illness Index, Stroke Volume, Time Factors, Treatment Outcome, Ventricular Dysfunction, Left/diagnostic imaging, Ventricular Function, Left, Ventricular Remodeling

ID: 57892022