Jurić M, Rupcić V, Topuzović N, Jakić M, Brlosić R, Rusić A, Karner I, Stipanić S, Kes P
Department of Cardiology, Osijek Clinical Hospital, Croatia.
Nephrol Dial Transplant. 1995;10(8):1398-404.
The aim of our study was to evaluate cardiovascular function at rest and during exercise in dialysis patients before and after treatment with Epo and to examine the changes in left ventricular mass as the consequence of treatment for anaemia. We applied echocardiography and radionuclide ventriculography at rest and after exercise in our research. Following treatment with Epo there was a decrease in the initially high cardiac output (CO) and cardiac index (CI) from 7.5 to 6.31/min and from 4.3 to 3.61/min/m2 respectively. No changes were noted in mean diastolic (DPB) and mean blood pressure (MBP), as well as the initially increased peripheral resistance index (TPRi) of 2582.3 +/- 2097.3 dyn-s-cm-5.m2. Nevertheless, end-diastolic (EDV) and end-systolic (ESV) volume were significantly decreased (P < 0.05), but the ejection fraction (EF) remained unchanged (73.9%). The decrease in the mean values for left ventricular mass (LVM) was significant only within the subgroup of dialysed patients who initially had larger left ventricular mass (P < 0.01). The functional capacity of the CV system measured during exercise increased from four metabolic equivalents (METs) to 6 METs (P < 0.01). A significant increase in blood volume was also observed following treatment of anaemia. The haemodynamic consequences of Epo therapy for the treatment of anaemia were quite positive. However, we would like to point out certain concerns regarding the dialysed patients with initially lower values for left ventricular mass and cardiac output, since the patients within this group developed left ventricular hypertrophy and an increase in cardiac output.
我们研究的目的是评估接受促红细胞生成素（Epo）治疗前后透析患者静息和运动时的心血管功能，并检查贫血治疗后左心室质量的变化。在我们的研究中，我们在静息和运动后应用了超声心动图和放射性核素心室造影。接受Epo治疗后，最初较高的心输出量（CO）和心脏指数（CI）分别从7.5降至6.3升/分钟和从4.3降至3.6升/分钟/平方米。平均舒张压（DPB）、平均血压（MBP）以及最初升高的外周阻力指数（TPRi）2582.3±2097.3达因-秒-厘米-5·平方米均未发生变化。然而，舒张末期容积（EDV）和收缩末期容积（ESV）显著降低（P<0.05），但射血分数（EF）保持不变（73.9%）。仅在最初左心室质量较大的透析患者亚组中，左心室质量（LVM）的平均值下降显著（P<0.01）。运动时测量的心血管系统功能能力从4个代谢当量（METs）增加到6个METs（P<0.01）。贫血治疗后还观察到血容量显著增加。Epo治疗贫血的血流动力学后果相当积极。然而，我们想指出对于最初左心室质量和心输出量较低的透析患者存在的某些担忧，因为该组患者出现了左心室肥厚和心输出量增加。
