Influence of hemodialysis on echocardiographic Doppler indices of the left ventricle: changes in parameters of systolic and diastolic function and Tei index

Koga, Seiji; Ikeda, Satoshi; Matsunaga, Kazuki; Naito, Takeo; Miyahara, Yoshiyuki; Taura, Koichi; Kohno, Shigeru

doi:10.5414/cnp59180

Cited by 23 publications

(20 citation statements)

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“…Since HT, DM, coronary artery disease, and heart failure are frequently seen in patients undergoing hemodialysis, diastolic dysfunction frequently accompanies to ESRD in this group of patients [16][17][18]. It was shown that RV function is adversely aff ected in the presence of HT [19] and DM [20].…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of right ventricular functions in nondiabetic normotensive hemodialysis patients

Karaveli̇oğlu

Özkurt

Kalçık

et al. 2015

IMAS

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Abstract:Purpose: Heart is aff ected structurally and functionally in end-stage renal disease (ESRD). However, the data available about adverse eff ects of ESRD on right ventricle (RV) is scarce. We aimed to evaluate echocardiographic parameters of RV in nondiabetic, normotensive patients with ESRD undergoing hemodialysis (HD). Methods: A total of 45 (24 women; mean age 52.4 ± 12.4 years) consecutive nondiabetic, normotensive patients with ESRD undergoing HD and 39 healthy age and sex-matched control subjects (22 women; mean age 50.3 ± 6.6 years) were enrolled in the study. M-mode and two dimensional images, color, pulsed and continuous wave Doppler, and tissue Doppler measurements were acquired from all subjects. Echocardiographic evaluation was performed in the days between HD dates of the patients. Results: RV fractional area change, tricuspid annular plane systolic excursion, tricuspid E velocity, E/A ratio, tricuspid annular E´ velocity, and E´/A´ ratio were lower in patients than controls (p < 0.001, p = 0.003, p = 0.007, p = 0.005, p < 0.001, and p = 0.034, respectively). However, RV diastolic area, RV myocardial performance index, E/E´ ratio, and mean and systolic pulmonary artery pressure were higher in patients than controls (p < 0.001, p = 0.007, p = 0.005, p < 0.001, p = 0.006, respectively). Conclusions: RV systolic and diastolic functions of nondiabetic, normotensive HD patients are deteriorated as compared to healthy controls.

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Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of right ventricular functions in nondiabetic normotensive hemodialysis patients

Karaveli̇oğlu

Özkurt

Kalçık

et al. 2015

IMAS

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“…Among the parameters included in the formula for calculating the Tei-index, only isovolumic contraction time significantly shortened, which can reflect the reduction in left ventricular afterload after nCPAP. The Tei-index is preload dependent 3,13 and nCPAP also reduces left ventricular preload by reducing end-diastolic volume and pressure 14,15 .…”

Section: Discussionmentioning

confidence: 99%

“…Transthoracic echocardiography was performed using an SSD-5500 echocardiograph (Aloka, Japan) and echocardiographic parameters were obtained as described 3 . Left ventricular ejection fraction was calculated using the Teichholz method, and left ventricular mass and left ventricular mass index were calculated using the formula reported by Devereux et al 4 .…”

Section: Methodsmentioning

confidence: 99%

Effect of Nasal Continuous Positive Airway Pressure in Men on Global Left Ventricular Myocardial Performance in Patients With Obstructive Sleep Apnea Syndrome

Koga

Ikeda

Urata

et al. 2008

The American Journal of Cardiology

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The influence of obstructive sleep apnea syndrome (OSAS) on left ventricular function remains controversial. We examined the influence of OSAS on global left ventricular function using the myocardial performance index (Tei-index) and plasma brain natriuretic peptide (BNP) level, and investigated the effect of nasal continuous positive airway pressure (nCPAP) on these parameters. We obtained echocardiographic indices including the Tei-index and BNP concentrations from 27 patients with OSAS whose mean apnea-hypopnea index (AHI) was 42.2 ± 21.5 events/hour and who were undergoing nCPAP, as well as from 22 control individuals. We defined global left ventricular dysfunction (GLVD) as a Tei-index of ≥ 0.50, and high BNP as ≥ 20 pg/ml. Compared with controls, the Tei-index of OSAS patients was significantly increased (P < 0.01) and the prevalence of GLVD was high (19%, P < 0.05). The correlation between the Tei-index and AHI was significant (r = 0.447, P < 0.05). Although BNP levels were higher in OSAS patients than in controls, the difference did not reach significance. The BNP level was high in 37% of OSAS patients and in only 9% of controls (P < 0.05). The Tei-index of OSAS patients was significantly decreased after 1 and 3 months of nCPAP (P < 0.01), and the prevalence of GLVD significantly decreased from 19% to 4% (P < 0.05). In contrast, BNP significantly decreased at 3 months after nCPAP (P < 0.05). In conclusion, patients with moderate to severe OSAS frequently have impaired global left ventricular myocardial performance, which can be reversed at the early stage after starting nCPAP.

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“…Their roles as markers of cardiac dysfunction are limited in HD patients because preload status affects the value. [25][26][27] It has been reported that the peak E increase is associated with an increase in LA pressure or a decrease in LV compliance, resulting in an increase in the peak E/peak A and the occurrence of a pseudonormalized or restrictive pattern of transmitral flow velocity. [28][29][30] Evaluation of E/A in HD patients is complicated.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Congestive Heart Failure in Patients on Maintenance Hemodialysis

Ito¹,

Murai²,

Sugiura³

et al. 2007

Circ J

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Background Cardiovascular disease is a major cause of death in patients on maintenance hemodialysis (HD). Predictors of congestive heart failure (CHF) events in patients on HD were investigated, focusing on left ventricular (LV) function. Methods and ResultsOne hundred consecutive patients on HD were followed for at least 5 years after index examination performed 1 day after the last HD session. Tests included M-mode and Doppler echocardiography and plasma brain natriuretic peptide (BNP) and hemoglobin (Hb) concentration measurements. Patients with atrial fibrillation or poor echocardiographic images were excluded. Confounding factors included diabetes mellitus (DM), hypertension, age, HD duration, LV fractional shortening, E/A of transmitral flow velocity pattern, Tei index, LV mass index (LVMI), BNP level, Hb, and use of antihypertensive or antiarrhythmic drugs. Six CHF events occurred during 1,703±565 days. DM and Hb <10 g/dl were identified as independent predictors of CHF events in a stepwise Cox regression model after DM, LVMI, BNP, and Hb <10 g/dl were selected in the univariate analysis. The hazard ratio (confidence interval) was 10.96 (1.49-80.44) for DM, and 23.00 (2.41-219.76) for Hb <10 g/dl. The estimated hazard across time was constant (T_COV*DM; p=0.726, T_COV*Hb <10 g/dl; p=0.681) by time-dependent covariates analysis. Conclusion In patients on maintenance HD, DM and anemia (Hb <10 g/dl), but not echo-derived cardiac function, predicted CHF events. (Circ J 2007; 71: 1424 -1429

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Influence of hemodialysis on echocardiographic Doppler indices of the left ventricle: changes in parameters of systolic and diastolic function and Tei index

Cited by 23 publications

References 0 publications

Echocardiographic assessment of right ventricular functions in nondiabetic normotensive hemodialysis patients

Echocardiographic assessment of right ventricular functions in nondiabetic normotensive hemodialysis patients

Effect of Nasal Continuous Positive Airway Pressure in Men on Global Left Ventricular Myocardial Performance in Patients With Obstructive Sleep Apnea Syndrome

Predictors of Congestive Heart Failure in Patients on Maintenance Hemodialysis

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