MO729: Chronic Heart Failure in Haemodialysis Patients

Abstract

Abstract BACKGROUND AND AIMS Left ventricular hypertrophy (LVH) and chronic heart failure (CHF) develop before the initiation of renal replacement therapy in most patients. Haemodialysis significantly changes the clinical of CHF. But the problem of CHF in haemodialysis patients remains extremely urgent because CHF is one of the most important causes of the development of life-threatening heart rhythm disturbances, which are the direct cause of death in haemodialysis patients. The aim of this study was to investigate the prevalence of symptomatic (NYHA Class II-IV) CHF in haemodialysis patients. METHOD Haemodialysis patients (n = 159; 77 males, 82 females, mean age was 55.6 ± 12.5 years) were studied. Echocardiography and Doppler echocardiography were performed according to the criteria of the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Left ventricular mass index (LVMI) was calculated. Left ventricular ejection fraction (LVEF) was measured by the echocardiographic Simpson method. The parameters of left ventricular diastolic function were evaluated by Doppler echocardiography. CHF was diagnosed according to criteria of the guidelines for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (2016). In addition, the assessment of CHF was carried out according to the ADQI heart failure in ESRD classification system (Table 1). RESULTS LVH was diagnosed in 116 (73%) patients. LVMI was 123.23 ± 22.32 g/m2. Concentric left ventricular hypertrophy was revealed in 106 (66.7%) patients, eccentric left ventricular hypertrophy was in 10 (6.3%) patients, concentric left ventricular remodelling was in 34 (21.4%) patients. Left atrial volume index > 34 mL/m2 was identified in 98 (61.6%) patients. E/e’≥13 was determined in 31 (19.5%) patients. Only 6 (3.8%) patients had LVEF˂50%. Symptoms of CHF were found in 49 (30.8%) patients. Class 2R was in 4 (2.5%) patients, class 2NR was in 36 (22.6%) patients, class 3R was in 1 (0.6%) patient and class 3NR was in 8 (5%) patients. CONCLUSION LVH was diagnosed in 73% haemodialysis patients. Most patients have left ventricular diastolic dysfunction. Symptoms of CHF were detected in 30.8% patients. These symptoms persist after RRT/UF in most patients.