Effects of Hemodialysis on Myocardial Function in Pediatric Patients

Abstract

The effect of hemodialysis on myocardial function in 10 pediatric chronic hemodialysis patients was assessed utilizing echocardiography. Parameters of cardiac function were measured prior to and immediately after dialysis. A significant decrease in cardiac output was observed post-dialysis. Unlike that observed in adult patients a real improvement in myocardial function as indicated by an increase in the mean velocity of circumferential fibre shortening was evident post-dialysis.

Acute Effects of Haemodialysis on Left Heart Dimensions and Left Ventricular Function: An Echocardiographic Study

“…Echocardiography revealed a significant decrease in heart size (LA, Dd and Ds) after dialysis, as reported before [9,11,12]. The effect of dialysis on left ventricular function has varied among previous studies.…”

“…Most previous studies using systolic time interval measurements and M-mode echocardiography have docu mented normal cardiac performance in uraemic patients on dialysis [7][8][9]11,12] despite the high prevalence of left ventricular hypertrophy. In the present study, 7 out of 25 patients (28%) had depressed left ventricular function, as assessed by Fs and VCF pre-dialysis (patients in group B).…”

“…[7], using systolic time intervals, noted an increase in pre ejection period with reduced left ventricular ejection time post-haemodialysis: this they attributed to a reduced pre load after dialysis (Starling effect) and not to a decline in myocardial contractile state. O'Regan et al [12] studied 10 paediatric patients and found improvement in myocardial function, as assessed by mean VCF, post-dialysis. This improvement occurred despite the fact that only 1 of their patients had impaired left ventricular function (VCF < 1.0 circ./s) pre-dialysis.…”

“…The non-invasive nature of systolic time interval meas urements and echocardiography has attracted several studies of left ventricular morphology and function in chronic haemodialysis patients [7][8][9][10][11][12]. These studies have generally documented a high prevalence of left ventricular hypertrophy and dilatation in these patients, but the pre valence of abnormal left ventricular function has been low.…”

The effect of extracorporeal high blood flow rate on left ventricular function during hemodialysis—an echocardiography study

“…Some authors suggested that noninvasive techniques have a positive effect on cardiac performance in children and adults undergoing hemodialysis. [18][19][20] This positive effect has been attributed by some authors to reduction of serum potassium during dialysis?I and by others to an increase of serum ionized-Ca concentration during hemodialysis.22. 23 Others suggested that improvement of cardiac function is more accentuated after bicarbonate than after acetate hem~dialysis.~~ In most previous studies cadiac performance was evaluated before and after hemodialysis and no study addressed the effect of increased BFR on LV contractility in a controlled and prospective manner.…”