Ersan Demirci Duygu, Demirci Deniz, Çoban Melahat, Yılmaz Öztekin Gülsüm Meral, Arslan Şakir
Department of Cardiology, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey.
Department of Nephrology, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey.
Turk Kardiyol Dern Ars. 2019 Mar;47(2):88-94. doi: 10.5543/tkda.2018.31391.
Cardiovascular disease is the leading cause of mortality in patients undergoing dialysis. Most of the available studies focus on left ventricular (LV) function in peritoneal dialysis (PD) patients; data about the effect of PD on right ventricular (RV) function are scarce. The aim of this study was to evaluate echocardiographic parameters of the RV in patients with end-stage renal disease (ESRD) undergoing PD.
A total of 73 individuals were grouped as follows: PD patients (n=36) and healthy controls (n=37). Echocardiography of the RV was performed in all of the patients using tissue Doppler imaging (TDI).
The LV mass index (LVMI), left atrial (LA) diameter, posterior wall, and interventricular septum thicknesses were significantly greater in the PD group. The LV peak late diastolic atrial contraction (A) velocity was higher, and the peak early diastolic (E) velocity and the early diastolic velocity of the lateral mitral annulus (Em) were lower in the PD group compared with the control group. The right atrial (RA) diameter, RA area, RV fractional area change, RV myocardial performance index, and pulmonary vascular resistance values were similar in both groups, whereas the tricuspid annular plane systolic excursion (TAPSE) value was lower in the PD patients. The RV E; early diastolic (Ea), late diastolic (Aa), and systolic (Sa) velocities; deceleration time; and tricuspid regurgitation velocity were also similar in the 2 groups. Only the RV A velocity and the Ea/Aa ratio were significantly higher in the PD group, and the E/A ratio was lower in the PD group than in the control group.
The results of conventional and TDI echocardiography indicated that RV systolic and diastolic functions were preserved in PD patients.
心血管疾病是接受透析治疗患者的主要死亡原因。大多数现有研究聚焦于腹膜透析（PD）患者的左心室（LV）功能；关于PD对右心室（RV）功能影响的数据较少。本研究旨在评估接受PD治疗的终末期肾病（ESRD）患者右心室的超声心动图参数。
共73人分为以下几组：PD患者（n = 36）和健康对照者（n = 37）。所有患者均使用组织多普勒成像（TDI）进行右心室超声心动图检查。
PD组的左心室质量指数（LVMI）、左心房（LA）直径、后壁厚度和室间隔厚度显著更大。与对照组相比，PD组左心室舒张末期心房收缩（A）峰值速度更高，舒张早期（E）峰值速度和二尖瓣环外侧舒张早期速度（Em）更低。两组的右心房（RA）直径、RA面积、右心室面积变化分数、右心室心肌性能指数和肺血管阻力值相似，而PD患者的三尖瓣环平面收缩期位移（TAPSE）值更低。两组的右心室E；舒张早期（Ea）、舒张晚期（Aa）和收缩期（Sa）速度；减速时间；以及三尖瓣反流速度也相似。仅PD组的右心室A速度和Ea/Aa比值显著更高，且PD组的E/A比值低于对照组。
传统超声心动图和TDI超声心动图结果表明，PD患者的右心室收缩和舒张功能得以保留。
