Abstract 14782: Pre- and Post-Hemodialysis Differences in Heart Failure Diagnosis by Current Heart Failure Guidelines in Patients With End-Stage Renal Disease

Abstract

Introduction: Patients with end-stage renal disease (ESRD) who are on hemodialysis (HD) have reduced vascular compliance and are likely to develop heart failure (HF). Hypothesis: This study estimated pre- and post-HD in ESRD HF diagnosis prevalence using the current guidelines. Methods: We prospectively investigated ESRD patients on HD using echocardiography between pre and post HD. We used structural or functional abnormality criteria of 2021 ESC guideline of HF Results: A total of 54 patients were enrolled. The mean age was 62.6 years and 40.1% were male. Forty-five patients (83.3%) had hypertension, 28 (51.9%) had diabetes, 20 (37.0%) had ischemic heart disease. Mean NT-pro BNP level was 11959.9pg/dL. The mean ideal body weight was 59.3kg, mean HD time was 237.4 minutes, and mean real filtration was 2.8 kg. The mean LVEF was 62.4% and mean LVEDD was 52.0 mm in pre-HD. Post-HD echocardiography showed significantly lower LAVI (33.3 ± 15.9 vs. 40.6 ± 17.1 ml/m 2 , p=0.030), TR jet V (2.5 ± 0.4 vs. 2.8 ± 0.4 m/s, p<0.001), and RVSP (32.1 ± 10.3 vs. 38.4 ± 11.6 mmHg, p=0.005) compared with pre-HD. There was no difference in LVEF, E/E’ ratio, or LV GLS. A total of 88.9% for pre-HD and 66.7% for post-HD had at least structural or functional abnormalities according to recent HF guidelines (p=0.007). Conclusions: Our data show that post-HD echocardiography showed significantly reduced LAVI, TR jet V and RVSP compared to pre-HD. The difference of prevalence of HF was 22.2% between pre- and post- HD.