Arinc Huseyin, Gunduz Huseyin, Tamer Ali, Ozhan Hakan, Akdemir Ramazan, Saglam Hayrettin, Oguzhan Abdurrahman, Uyan Cihangir
Department of Cardiology, Abant Izzet Baysal University, Izzet Baysal Medical Faculty, Kalicikonutlar, Bolu, Turkey.
Am J Nephrol. 2005 May-Jun;25(3):256-61. doi: 10.1159/000086080. Epub 2005 May 27.
Although there are plenty of data about the differences in left ventricular tissue Doppler (TD) velocities by preload reduction, only a few studies regarding right ventricular function are found in the literature. We investigated the effect of intravascular volume reduction on right ventricular function by ultrafiltration in dialysis patients.
27 end-stage renal failure patients who were hypervolemic and undergoing hemodialysis were included in the study. TD studies of the right ventricle were performed before and 1 h after dialysis. These data were compared.
The mean age of the patients was 41 +/- 15 years and mean volume of ultrafiltration was 3.8 +/- 1.8 liters. Systolic, early and late diastolic lateral annular TD velocities before dialysis were 0.109 +/- 0.029, 0.088 +/- 0.039, 0.111 +/- 0.039 m/s, and after dialysis were 0.099 +/- 0.028, 0.078 +/- 0.036, 0.106 +/- 0.037 m/s, respectively (p = 0.216, p = 0.112, p = 0.350). Myocardial early diastolic velocity decreased significantly (p = 0.049) but systolic and late diastolic velocities did not change significantly (p = 0.579, p = 0.146).
Right ventricular systolic and diastolic velocities detected by TD were not or only minimally affected by preload reduction in hemodialysis patients and the TD early/late ratio is the most valuable variable that can predict right ventricular diastolic function. The right ventricular systolic and early diastolic TD velocities were positively correlated with left ventricle ejection fraction.
尽管有大量关于通过降低前负荷来观察左心室组织多普勒(TD)速度差异的数据,但文献中关于右心室功能的研究却很少。我们研究了超滤对透析患者血管内容量减少时右心室功能的影响。
本研究纳入了27例处于高血容量状态且正在接受血液透析的终末期肾衰竭患者。在透析前和透析后1小时对右心室进行TD研究。对这些数据进行比较。
患者的平均年龄为41±15岁,平均超滤量为3.8±1.8升。透析前右心室侧壁收缩期、舒张早期和舒张晚期TD速度分别为0.109±0.029、0.088±0.039、0.111±0.039米/秒,透析后分别为0.099±0.028、0.078±0.036、0.106±0.037米/秒(p = 0.216,p = 0.112,p = 0.350)。心肌舒张早期速度显著降低(p = 0.049),但收缩期和舒张晚期速度无显著变化(p = 0.579,p = 0.146)。
血液透析患者中,通过TD检测到的右心室收缩期和舒张期速度未受或仅轻微受前负荷降低的影响,TD早/晚比值是预测右心室舒张功能最有价值的变量。右心室收缩期和舒张早期TD速度与左心室射血分数呈正相关。