Premium
Left ventricular mechanical dyssynchrony in patients with different stages of chronic kidney disease and the effects of hemodialysis
Author(s) -
Hayashi Shirley Yumi,
Nowak Jacek,
Lindholm Bengt,
Nascimento Marcelo Mazza do,
Lind Britta,
Bjällmark Anna,
Larsson Matilda,
Pachaly Maria Aparecida,
Seeberger Astrid,
Riella Miguel C.,
Brodin LarsÅke
Publication year - 2013
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12017
Subject(s) - medicine , cardiology , hemodialysis , kidney disease , synchronicity , left ventricular hypertrophy , dialysis , heart failure , peritoneal dialysis , diastole , ventricular dyssynchrony , muscle hypertrophy , blood pressure , cardiac resynchronization therapy , philosophy , ejection fraction , epistemology
Left ventricular ( LV ) dyssynchrony is a known cause of mortality in patients with heart failure and may possibly play a similar role in patients with chronic kidney disease ( CKD ) in whom sudden death is one of the most common and as yet not fully explained cause of death. LV synchronicity and its relationship with increased volume load and various biomarkers was analyzed in 145 patients including 53 patients with CKD stages 3 and 4 and in 92 CKD stage 5 patients undergoing hemodialysis ( HD ) or peritoneal dialysis ( PD ) using color tissue D oppler imaging and tissue synchronization imaging. The HD patients were evaluated both before and after a single HD session. LV dyssynchrony was defined as a regional difference in time to peak systolic myocardial velocity, between 12 LV segments > 105 milliseconds. LV dyssynchrony was present in 54% of the patients with no difference between CKD 3 and 4 (58%), HD (48%), and PD (51%). LV dyssynchrony was independently associated with LV mass index and increased estimation of LV end‐diastolic pressure. A single HD session resulted in significant changes in LV synchronicity variables—with improvement in 50% of the patients—especially in patients with higher myocardial systolic velocities and lower LV mass index. Abnormalities in LV synchronicity are highly prevalent in CKD patients already prior to dialysis treatment and are associated with LV hypertrophy, LV dysfunction and load conditions, underlining the importance of volume status for LV synchronicity in CKD patients.