Department of Nephrology, University Hospital of Split, 21000 Split, Croatia.
Department of Cardiology, University Hospital of Split, 21000 Split, Croatia.
Medicina (Kaunas). 2024 Sep 20;60(9):1537. doi: 10.3390/medicina60091537.
: The assessment of cardiac function in patients with end-stage renal disease (ESRD) is vital due to their high cardiovascular risk. However, contemporary echocardiographic indices and their association with hemodialysis-to-hemodiafiltration transfer are underreported in this population. : This prospective cohort study enrolled 36 ESRD patients undergoing hemodialysis-to-hemodiafiltration transfer, with baseline and 3-month post-transfer comprehensive echocardiographic assessments. The key parameters included the global work index, global constructed work, global wasted work (GWW), global work efficiency (GWE), and global longitudinal strain (GLS), with secondary measures from conventional echocardiography. The baseline measures were compared to general population reference values and changes pre- to post-transfer were analyzed using the Mann-Whitney U test. : Patients exhibited significant deviations from reference ranges in GWW (179.0 vs. 53.0-122.2 mmHg%), GWE (90.0 vs. 53.0-122.2%), and GLS (-16.0 vs. -24.0-(-16.0)%). Post-transfer left ventricular myocardial work and longitudinal strain remained unchanged ( > 0.05), except for increased GWW (179.0, IQR 148.0-217.0 to 233.5, IQR 159.0-315.0 mmHg%, = 0.037) and improved mid-inferior peak systolic longitudinal strain ((-17.0, IQR -19.0-(-11.0) to -18.7, IQR -20.0-(-18.0)%, = 0.016). The enrolled patients also showed higher left atrial diameters, left ventricular volumes, and mass, with impaired systolic function in both ventricles compared to reference values. : This study highlights baseline impairments in contemporary echocardiographic measures (GWW, GWE, GLS) in ESRD patients versus reference values, but found no association between hemodialysis-to-hemodiafiltration transfer and most myocardial work and strain parameters.
：由于终末期肾病（ESRD）患者心血管风险较高，因此评估其心功能至关重要。然而，该人群中当代超声心动图指标及其与血液透析到血液透析滤过转换的关系报道较少。
：这项前瞻性队列研究纳入了 36 名正在进行血液透析到血液透析滤过转换的 ESRD 患者，在基线和 3 个月的转后进行全面的超声心动图评估。关键参数包括整体做功指数、整体构建做功、整体无效做功（GWW）、整体做功效率（GWE）和整体纵向应变（GLS），以及来自常规超声心动图的次要指标。将基线测量值与一般人群参考值进行比较，并使用 Mann-Whitney U 检验分析转前至转后的变化。
：患者的 GWW（179.0 比 53.0-122.2mmHg%）、GWE（90.0 比 53.0-122.2%）和 GLS（-16.0 比-24.0-（-16.0）%）明显偏离参考范围。除 GWW 增加（179.0，IQR 148.0-217.0 到 233.5，IQR 159.0-315.0mmHg%，=0.037）和中间下壁收缩期纵向应变改善（-17.0，IQR-19.0-（-11.0）到-18.7，IQR-20.0-（-18.0）%，=0.016）外，转后左心室心肌做功和纵向应变保持不变（>0.05）。与参考值相比，纳入的患者还表现出更高的左心房直径、左心室容积和质量，以及两个心室的收缩功能受损。
：本研究强调了与参考值相比，ESRD 患者在基线时存在当代超声心动图指标（GWW、GWE、GLS）的损害，但在血液透析到血液透析滤过转换与大多数心肌做功和应变参数之间未发现关联。
