No Harmful Effect of Dialysis-Induced Hypotension on the Myocardium in Patients Who Have Normal Ejection Fraction and a Negative Exercise Test

Abstract

Background: We investigated the effects of dialysis-induced hypotension (DIH) on the myocardium of patients who have a normal ejection fraction and normal treadmill stress tests. Methods: This study included 26 end-stage renal disease (ESRD) patients with DIH, 30 ESRD patients without DIH (non-DIH), and 30 control subjects. Mitral-myocardial systolic velocity (MSV), the mitral E′/A′ ratio, the left ventricle filling pressure index (E/E′ ratio), tricuspid-MSV, and the tricuspid E′/A′ ratio were calculated. Results: Biventricular systolic and diastolic functions were impaired in dialysis patients. The mitral and tricuspid MSV were similar between DIH and non-DIH patients (8.03 ± 0.90 cm/s vs. 8.31 ± 1.68 cm/s, p = 0.896, and 13.27 ± 2.97 cm/s vs. 13.15 ± 2.37 cm/s, p = 0.980). Mitral and tricuspid E′/A′ were similar between DIH and non-DIH patients. (1.30 ± 0.53 vs. 1.16 ± 0.56, p = 0.695, and 0.70 ± 0.24 vs. 0.68 ± 0.33, p = 0.976). Likewise, the E/E′ ratio was similar between DIH and non-DIH patients (8.20 ± 2.83 vs. 8.28 ± 2.53, p = 0.990). Conclusion: Although biventricular systolic and diastolic function is impaired in dialysis patients compared to controls, DIH episodes did not have an adverse effect on the myocardial functions.

Association between angiopoietin‐2 and functional cardiac remodeling in hemodialysis patients with normal left ventricular ejection

“…Also, although our cohort is from maintenance HD patients, all patients had a LVEF >50%, explaining the reduced mean E/e’ and LVMi values. Such findings are in accordance with other studies in similar populations 37,38 …”

“…Such findings are in accordance with other studies in similar populations. 37,38 Our study has several limitations. First, the relatively small sample size of the study.…”

Effects of acute intradialytic exercise on cardiovascular responses in hemodialysis patients

“…Intradialytic hypotension (IDH) was defined as (1) systolic blood pressure (SBP) <90 mmHg, and/or (2) a fall of SBP of more than 25% from the start of HD associated with symptoms including dizziness, vomiting, nausea, and muscle cramps, and/or modifying dialysate temperature, stopping UF, or saline solution boluses. 15 Intradialytic hypertension (IDHTN) was an increase in mean arterial pressure (MAP) over 15 mmHg during or after an HD session. 16 Self-reported intradialytic symptoms were assessed by a questionnaire including symptoms of nausea, dizziness, and cramps, using a 5-point Likert scale, where 0 was no symptoms and 4 was severe.…”