Evaluation of a single hemodialysis on right ventricular function in patients by 3-dimensional speckle tracking imaging

Abstract

Objective To evaluate the change of right ventricular function before and after single hemodialysis by 3-dimensional speckle tracking imaging(3D-STI). Methods Seventy-six patients with end-stage renal disease(ESRD) and 35 controls were included.ESRD patients were divided into normal left ventricular ejection fraction group(LVEF≥50%, 46 cases, group A)and decreased LVEF group(LVEF<50%, 30 cases, group B). Conventional echocardiography and 3D-STI parameters including right ventricular end diastolic volume(RVEDV), right ventricular end systolic volume (RVESV), right ventricular ejection fraction(RVEF), right ventricular septal longitudinal strain[RVLS(Septum)], right ventricular free wall longitudinal strain [RVLS(Freewall )], basal segment of right ventricular diameter[RVDd(base )], right ventricular middle diameter [RVDd(mid )], right ventricular long diameter (RVLD) and the upper and lower right ventricular fractional area change (FAC) were performed in patients and controls before and after a single hemodialysis. Results ①RVEDV, RVESV, RVDd(base), RVDd(mid), RVLD before a single hemodialysis in group A and B were significantly higher than those in control group (all P<0.05). RVEF, RVLS Freewall, RVLS(Septum) and FAC in group A and B were significantly lower than those in control group (all P<0.05). ②RVEDV, RVESV, RVEF, RVLD, RVLS(Freewall) were significantly lower in group A after a single hemodialysis(all P<0.05); RVEDV, RVESV, RVEF, RVLS(Freewall), RVLS(Septum) were significantly lower in group B after a single hemodialysis(all P<0.05); RVEDV, RVESV, RVEF, RVLS(Septum) and RVLS(Freewall) in group B before a single hemodialysis were lower than those in group A (all P<0.05). The difference of RVLS Septum decrease in group B after a single hemodialysis was higher than that in group A(P<0.05); The linear correlations analysis showed that the difference of body weight before and after a single hemodialysis was negatively related with the difference of RVLS(Freewall) before and after a single hemodialysis(group A: r=0.351, P=0.017; group B: r=0.696, P=0.000). Conclusions A single hemodialysis may have injurious effects on right ventricular systolic function and reduce strain value, which is more significant in group B(LVEF<50%). Cardiac dysfunction of patients may be remitted by reasonable control of water intake. Key words: Echocardiography; End-stage renal disease; Hemodialysis; Ventricular function, right; Three-dimensional speckle tracking imaging