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The diastolic function abnormalities in hemodialysis session: a two-dimensional speckle tracking echocardiographic (2DSTE) study

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Abstract

Hemodialysis (HD) decreases preload and its acute effect on the diastolic function is still controversial even with the introduction of new non-volume-dependent tissue Doppler echocardiographic indices. This study is designed to evaluate these acute changes following HD sessions. We enrolled 39 patients receiving standard thrice weekly HD for more than 6 months and performed two dimensional speckle tracking echocardiography (2DSTE) and tissue Doppler studies with a standard cardiac ultrasound device shortly before and after HD. We observed significant changes in most of the transmitral flow and tissue Doppler echocardiographic parameters after HD. The left atrial volume index, left ventricular mass index, mitral E, mitral E/A, and lateral annular E/é levels decreased after HD (p: < 0.001, p: 0.026, p: < 0.001, p: 0.011, p: < 0.001, respectively). Medial á, medial myocardial performance index (MPI), medial ś, lateral ś, and lateral MPI values increased significantly after HD (p: 0.049, p: 0.007, p: 0.001, p: < 0.001, p: 0.01, respectively). Diastolic parameters like diastolic strain ratio early diastole (DSRE), diastolic strain ratio late diastole (DSRA), E/DSRE, and E/DSRA did not change significantly after HD (p: 0.716, p: 0.117, p: 0.114, and p: 0.211, respectively). The global longitudinal strain value obtained with 2DSTE worsened after HD (− 18.4 ± 4.0 before vs − 15.9 ± 5.4 after HD, p: 0.011). Transmitral flow and tissue Doppler parameters changed significantly after HD while the change in 2DSTE findings was not significant. The diastolic measurements made with 2DSTE may be less volume and cardiac preload dependent compared to conventional echocardiography and this may explain the difference.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey

    Hakan Kosku, Sule Sengul, Merve Aktar & Sim Kutlay

  2. Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey

    Cansin Tulunay Kaya & Muge Akbulut

  3. Ibni Sina Hastanesi Nefroloji BD, Ankara Universitesi Tıp Fakultesi, Samanpazari, 06100, Ankara, Turkey

    Sim Kutlay

Authors
  1. Hakan Kosku
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  2. Cansin Tulunay Kaya
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  3. Sule Sengul
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  4. Muge Akbulut
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  5. Merve Aktar
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  6. Sim Kutlay
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by HK, CTK, SS, MA, MA, and SK. The first draft of the manuscript was written by HK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Sim Kutlay.

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The authors have no relevant financial or non-financial interests to disclose. The authors declare that they have no conflict of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Ankara University Institutional Committee for Science and Research Ethics (2021, İ2-149-21).

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Informed consent was obtained from all individual participants included in the study.

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Kosku, H., Kaya, C.T., Sengul, S. et al. The diastolic function abnormalities in hemodialysis session: a two-dimensional speckle tracking echocardiographic (2DSTE) study. Int J Cardiovasc Imaging 38, 1453–1461 (2022). https://doi.org/10.1007/s10554-022-02535-w

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  • DOI: https://doi.org/10.1007/s10554-022-02535-w

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