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Myocardial stunning in hemodialysis: What is the overall message?
Author(s) -
DORAIRAJAN Smrita,
CHOCKALINGAM Anand,
MISRA Madhukar
Publication year - 2010
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/j.1542-4758.2010.00495.x
Subject(s) - medicine , hemodialysis , myocardial stunning , cardiology , heart failure , complication , etiology , population , hemodynamics , intensive care medicine , stunning , chronic renal failure , cardiac dysfunction , ischemia , environmental health
Heart failure and cardiovascular events are common in chronic renal failure. Hemodialysis (HD) causes significant hemodynamic changes and hypotension. New evidence based on intradialytic echocardiography demonstrates transient cardiac dysfunction or stunning in majority of chronic HD patients. Over time, this group may progress to chronic heart failure and appears to predict higher cardiovascular events and mortality. Although the exact etiology is unclear, alterations in HD technique and cardiac medications may reduce this complication. We review the current understanding of acute cardiac stunning during HD and present a systematic management algorithm to optimizing overall outcomes in this high‐risk population.