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Contractility Reserve in Children Undergoing Dialysis by Dobutamine Stress Echocardiography

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Abstract

Left ventricular hypertrophy is an adaptive mechanism in children undergoing chronic dialysis to improve contractility at rest. The aim of this study was to determine the left ventricular performance and contractility reserve by “dobutamine stress echocardiography” in children undergoing chronic dialysis. Thirty-five children undergoing dialysis and 24 healthy subjects were enrolled in this prospective study. We evaluated contractility by means of end-systolic wall stress—velocity of circumferential fiber shortening (VCFc) in 24 healthy subjects and 35 dialysis patients. Dobutamine stress echocardiography was obtained only in children undergoing dialysis. Patients were divided into two groups according to left ventricular mass index. Contractile reserve was estimated by the difference in contractility at rest versus during echocardiography. Significantly higher VCFc (p = 0.008) and VCFc (p = 0.002) differences at rest were observed in the patient group compared to healthy subjects. Children undergoing dialysis had a higher left ventricular mass index compared with controls (42.38 ± 12.41 vs. 17.57 ± 3.66 g/m2.7, respectively; p = 0.001). Patients with left ventricular hypertrophy had a significantly lower contractile reserve compared with patients without left ventricular hypertrophy (p = 0.013). These findings suggest that children undergoing dialysis have increased left ventricular mass and contractility at rest. However, the contractile reserve during dobutamine stress echocardiography was reduced. Dobutamine stress echocardiography may identify children undergoing dialysis at risk of progressing to systolic dysfunction and heart failure.

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Authors and Affiliations

  1. Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children’s Hospital, 1417 Alsancak Street, 35210, Izmir, Turkey

    Timur Mese, Baris Guven & Murat Muhtar Yilmazer

  2. Department of Pediatric Nephrology, Izmir Dr. Behcet Uz Children’s Hospital, Izmir, Turkey

    Erkin Serdaroglu

  3. Department of Pediatric Cardiology, Yeditepe University, Istanbul, Turkey

    Vedide Tavli

  4. Department of Pediatrics, Izmir Dr. Behcet Uz Children’s Hospital, Izmir, Turkey

    Ali Haydar

  5. Department of Pediatric Nephrology, Mugla University, Mugla, Turkey

    Mustafa Bak

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  1. Timur Mese
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  2. Baris Guven
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  3. Murat Muhtar Yilmazer
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  4. Erkin Serdaroglu
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  5. Vedide Tavli
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  6. Ali Haydar
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  7. Mustafa Bak
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Correspondence to Baris Guven.

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Mese, T., Guven, B., Yilmazer, M.M. et al. Contractility Reserve in Children Undergoing Dialysis by Dobutamine Stress Echocardiography. Pediatr Cardiol 31, 937–943 (2010). https://doi.org/10.1007/s00246-010-9721-x

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  • DOI: https://doi.org/10.1007/s00246-010-9721-x

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