[Does echocardiography Tm permit to determine the true contractile state of the left ventricle of hemodialysis patients? (author's transl)].

M. mode echocardiography was performed on 16 chronic hemodialysis patients (12 men, 4 women, average use of 21, hematocrit around 24 +/- 5%) with a normal blood pressure and no clinical or roentgenographic signs of heart failure, 18 to 22 hours after the end of a dialysis. Renal diseases due to hypertension, diabetes or amyloidosis were excluded from the study. 8 normal subjects of similar age, heart rate and blood pressure were used as a test group. On these 24 persons, and diastolic time diameter index (DTDI) and end systolic time diameter index (STDI), ejection time (ET), mean velocity of circumferential fiber shortening (VCF) and ejection fraction were calculated. DTDI of hemodialysis patients (31 mm/m(2) +/- 2) is greater than DTDI of the control subjects, and STDI and ET are the same. This explains the increase of VCF (1,69 +/- 0,10 c/s) and EF (0,78 +/- 0,05). After a three minute compression of the fistulas the differences disappear. These results suggest that the previous exam conditions permit a better determination of the true contractile state of the left ventricule of hemodialyzed patients if one disregards the load changes due to the fistula, anemia and the intermittent volume expansion.