Echocardiographic parameters in hemodialysis patients

Abstract

Introduction Cardiovascular morbidity and mortality appears to be higher in patients with end stage renal disease in chronic hemodialysis. Detection of abnormalities in cardiac structure or function allows appropriate therapeutic management. Transthoracic echocardiography (TTE) is a non-invasive, available and reproducible tool that allows the diagnosis of cardiac abnormalities particularly in this population. Methodes We conducted a retrospective study including hemodialysis patients at our dialysis unit and having an echocardiography performed more than 3 months from the beginning of the extrarenal treatment. We selected 31 patients. Resultats obtenus ou attendus The mean age of patients was 51.9 years. Hypertension was found in 83.8 %, diabetes in 22.5 % and coronary event in 25.8%. The electrocardiogram showed repolarization abnormalities in 29%, arhythmia in 16.1% and left ventricular hypertrophy in 22.5%. The mean duration of hemodialysis was 73.1 months. The frequency of hemodialysis was 3 per week in most patients. Echocardiography showed dilatation of the left atrium (LA) in 64.5% and dilatation of the right cavities in 25.8%. Left ventricular (LV) hypertrophy was found in 41.9% with an average thickness of the inter ventricular septum and the posterior wall of 13.43 mm and 10.96 mm respectively. The mean LV end-diastolic pressure was calculated at 49.8 mmHg. Dilated cardiomyopathy was noted in only 3 patients. The kinetic was conserved in 67.7% whereas a total hypokinesia was found in 12.9% and segmental hypokinesia in 19.3%. Valvulopathy was found in 54.8%. Valvular calcifications were noted in 25.8%. 54% of patients had pulmonary arterial hypertension with an average pulmonary arterial systolic pressure of 41.1 mmHg. Pericarditis was found in 32.2%, while 57.2% of patients had previous pericarditis including a patient with a drained tamponade. The inferior vena cava was dilated in 29%. Conclusion Cardiac complications are frequent in hemodialysis population and are dominated by left ventricular hypertrophy and increased preload due to several factors.