Echocardiographic evaluation of right heart functions in hemodialysis patients
Keywords:Right heart functions, Tricuspid annular plane systolic excursion, Systolic pulmonary artery pressure, Hemodialysis
Aim: Volume load assessment is an important problem in patients with chronic renal failure (CRF). Apart from classical volume assessment methods, the number of studies on echocardiographic evaluation of right heart functions is limited. In this study, we aimed to evaluate right heart functions echocardiographically in end-stage renal failure patients receiving hemodialysis (HD) therapy and its utility in volume load determination.
Methods: This case-control study included 49 patients receiving HD treatment as the study group. The control group consisted of 46 healthy individuals whose age and gender were matched. Echocardiographic evaluation was performed for all participants. Tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (SPAB), tricuspid E wave velocity, A wave velocity, E / A ratio, right ventricular ejection fraction (RVEF) and left ventricular ejection fraction (LVEF) were measured.
Results: Right ventricular diastolic diameter (2.55 (0.3) vs 2.30 (0.29) respectively, P<0.001) SPAP (37.4 (8.3) vs 19 (6.8), P<0.001, respectively) were statistically significant higher in the study group, while TAPSE (1.61 (0.35) vs 2.09 (0.27), P<0.001, respectively), A rate, (0.63 (0.27) vs 0.45 (0.26), P<0.001, respectively), E / A ratio (0.93 (0.25) vs 1.37 (0.24), P<0.001, respectively) were significantly lower. Right ventricular (RV) E velocity was insignificantly lower in the study group (P=0.523). There were no statistically significant differences between the groups in terms of age, gender, and body mass index.
Conclusion: In our study, we found that TAPSE was low and SBAP and RV diastolic diameter were high in HD patients. We think that TAPSE and SPAB can be used together with conventional methods for evaluating hypervolemia in HD patients. Further studies are required to explore this clinical tool.
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