Klinische Wochenschrift

, Volume 67, Issue 16, pp 826–832 | Cite as

Doppler echocardiographic analysis of diastolic left ventricular function in dialysis patients and its relation to intradialytic hypotension

  • C. Punzengruber
  • M. Wallner
Originalien

Summary

Doppler echocardiography was used to evaluate left ventricular relaxation and filling in 20 patients on chronic maintenance hemodialysis. In comparison with 11 normal controls hemodialysed patients showed a marked prolongation of isovolumic relaxation period (83±23 ms vs 67±11 ms,P<0.01). Peak velocity of early diastolic filling was similar in both groups, but peak velocity of late ventricular filling due to atrial contraction was substantially increased in dialysis patients (66±23 cm/s vs 37±7 cm/s,P<0.01) and the ratio late to early peak velocity was significantly enlarged (0.97±0.35 vs 0.58±0.19,P<0.01). Although left ventricular mass index, as determined by Echo, was markedly increased in dialysis patients, no significant correlation was found between ventricular mass and indexes of diastolic function. When patients were divided into two groups on the basis of development of hypotension during dialysis clinical and echocardiographic characteristics were similar, although patients with dialysis hypotension (n=9) were significantly older (53±9 years) than normotensiv patients (n=11, 42±14 years,P<0.05). Indexes of diastolic function showed a great overlap between the two groups, but ratio late to early peak velocity was significantly greater in patients with intradialytic hypotension (1.13±0.35 vs 0.83±0.32,P<0.05). It is concluded that dialysis patients exhibit significant alterations of left ventricular relaxation and diastolic filling as assessed by Doppler echocardiography which might be independent of left ventricular hypertrophy. Impaired diastolic function might contribute to intradialytic hypotension.

Key words

Hemodialysis Diastolic left ventricular function Doppler echocardiography 

Abbreviations

DEF

deceleration of early diastolic flow

IVRP

isovolumic relaxation period

peakA

peak velocity of late left ventricular filling

peakE

peak velocity of early left ventricular filling

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Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • C. Punzengruber
    • 1
  • M. Wallner
    • 2
  1. 1.Abteilung für Kardiologie des A.Ö. Krankenhauses der Barmh. Schwestern vom Hl. KreuzWelsÖsterreich
  2. 2.Abteilung für Nephrologie des A.Ö. Krankenhauses der Barmh. Schwestern vom Hl. KreuzWelsÖsterreich

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