ISSN : 2146-3123
E-ISSN : 2146-3131

Acute Haemodialysis-induced Changes in Tissue Doppler Echocardiography Parameters
Saim Sağ 1, Dilek Yeşilbursa 1, Tunay Şentürk 1, Osman Akın Serdar 1, Ali Aydınlar 1, Abdulmecit Yıldız 2, Kamil Dilek 3
1Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey
2Department of Nephrology, Uludağ University Faculty of Medicine, Bursa, Turkey
3Department of Nephrology, Uludağ University Faculty of Medicine, Bursa, Turkey
DOI : 10.5152/balkanmedj.2014.13170
Pages : 239-243


Background: Tissue Doppler imaging (TDI) is a method that determines the tissue motion and velocity within the myocardium.

Aims: To characterize acute haemodialysis (HD)-induced changes in TDI-derived indices for patients that have end-stage renal disease (ESRD).

Study Design: Cross sectional study.

Methods: Conventional echocardiography and TDI methods were applied to study ESRD patients (n=58) before and after HD.  Pulmonary venous flow, mitral inflow, and TDI signals of the lateral and septal mitral annulus were examined for the determination of altered left-ventricular diastolic filling parameters. Flow velocities from early- (E) and late-atrial (A) peak transmitral; peak pulmonary vein systolic (S) and diastolic (D); and myocardial peak systolic (Sm) and peak early (Em) and late (Am) diastolic mitral annular velocities were also assessed for changes.

Results: Transmitral E and A velocities and the E/A ratio decreased significantly after HD (p<0.001). Pulmonary vein S (p<0.001) and D (p<0.001) velocities decreased, and S/D ratios increased significantly (p=0.027). HD led to a reduction in septal Em (p<0.001), lateral Em (p=0.006), and Am (p<0.001) velocities. Contrary to the decreases in Em and Am, the Em/Am ratio remained unchanged.

Conclusion: A single HD session was associated with an acute deterioration in the diastolic parameters. Since the Em/Am ratio remained unchanged, we conclude that this index is a relatively load-independent measure of diastolic function in HD patients.

Keywords : Echocardiography, haemodialysis, left ventricular systolic and diastolic function, tissue Doppler imaging
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