Peripheral arterial response during haemodialysis – is two-dimensional speckle-tracking a useful arterial reactivity assessment tool?

Abstract

Aim: 2D speckle tracking is a method used in myocardial strain assessment. However, several studies have confirmed the suitability of its application in the assessment of arterial strain (a marker of arterial stiffness). The aims of our study were to evaluate whether 2D speckle tracking can assess the changes in carotid and femoral strain caused by fluid loss during haemodialysis, and to determine the direction and amount of these changes. Material and methods: We examined the distal common carotid and proximal femoral arteries in 74 haemodialysed patients (28 women and 46 men) before and after their haemodialysis sessions. EchoPac software was used to analyse the recorded ultrasound examinations. Circumferential strain values were acquired for further analysis. Results: We found a decrease in carotid circumferential strain values after haemodialysis sessions (5.916 ± 2.632% before haemodialysis and 4.909 ± 2.409% after haemodialysis, p = 0.000022). The amount of fluid lost during haemodialysis sessions correlated (correlation coefficient of 0.434, p = 0.000222) with the decrease of carotid circumferential strain. The correlation coefficients were slightly higher (0.445, p = 0.000146) when a ratio of fluid loss volume to the BMI was used. No statistically significant changes were found in femoral circumferential strain. Conclusions: Our findings suggest that arterial response to body fluid loss may be assessed by 2D speckle tracking. This method enabled us to measure carotid circumferential strain changes caused by fluid volume contraction during haemodialysis sessions. We found an important decrease in the carotid circumferential strain values after the procedure. The amount of this decrease correlated significantly with the decrease in the volume of fluid lost during the haemodialysis session.

Circumferential Strain as a Marker of Vessel Reactivity in Patients with Intradialytic Hypotension

“…EchoPac software was used for the analysis ( Figure 1 ). Detailed data of the analysis were described in another study [ 35 ].…”

“…It has been proven that, at least to some extent, these parameters (in particular CS) can be used to assess the local stiffness of vessels [ 32 , 33 , 34 ]. In our previous research, it was found that CS values decrease significantly in correlation with ultrafiltration volume during HD sessions [ 35 ]. This observation suggests that CS may be a parameter that shows the effectiveness of the cardiovascular response to a reduction of circulating plasma volume, and therefore correlate with the incidence of IDH.…”