Color M-mode flow propagation velocity versus conventional Doppler indices in the assessment of diastolic left ventricular function in patients on chronic hemodialysis.

Abstract

Color M-mode flow propagation velocity (Vp) has been reported as a preload-independent measure of diastolic function. To study the effects of loading conditions on diastolic function assessment in patients on chronic hemodialysis, we measured Vp and conventional Doppler indices pre- and posthemodialysis. Twenty hemodialysis patients with normal systolic function underwent measurement of Vp, early filling velocity (E), its deceleration time (DT), atrial contraction velocity (A), isovolumic relaxation time (IVRT), and pulmonary atrial flow reversal velocity (PFR) pre- and posthemodialysis. Twelve healthy controls underwent these same measurements. Hemodialysis patients had significantly slower Vp at baseline than normal controls, while E/A, DT, IVRT, and pulmonary flow reversal were not significantly different. E, IVRT, and PFR were affected by hemodialysis, while color M-mode flow propagation velocities, A, and DT were not. Color M-mode flow propagation velocity seems to be a preload-independent measure of diastolic function in chronic hemodialysis patients in whom isolated diastolic dysfunction appears prevalent.