[Asymmetric hypertrophy of the intraventricular septum in normotensive patients with chronic uremia during hemodialysis therapy. M-mode echocardiographic study].

Cardiovascular complications are very common in uraemic patients on regular dialytic treatment and are often the cause of death. In these patients many echocardiographic studies have been carried out to establish the presence of cardiac alterations. In particular some M-mode echocardiographic investigating have shown a significant incidence of asymmetric septal hypertrophy (ASH), but often the patients had associated cardiomegaly or arterial hypertension. In the present paper M-mode echocardiogram and carotid pulse tracing were recorded after dialysis in 23 normotensive long-term hemodialyzed patients. The aim of the study was to detect the incidence of ASH and to assess the functional behaviour of the left ventricle in relation to the presence of the septal abnormality. ASH as ratio of interventricular septal to posterior wall thickness (IVS/PWT) of 1.3 or greater, without systolic anterior motion of anterior mitral leaflet (SAM), was found in 52.1% of patients. The group with ASH showed an obvious reduction of the cardiac index (CI), after dialysis, due to reduction of left ventricular size and to the abnormal septal function. CI was normal in patients without ASH. On the other hand the presence of ASH did not significantly influence the percentage of fractional shortening (FS%), the velocity of circumferential fiber shortening (Vcf) and the ejection fraction (EF%) which were similar in both groups of patients. A long-term echocardiographic follow-up of these patients may be important to outline the natural history of ASH and to evaluate its relation to chronic renal failure on hemodialytic treatment.