Echocardiographic assessment of systolic time intervals in hemodialysis patients with normal ejection fraction
Journal Title: International Archives of Integrated Medicine - Year 2019, Vol 6, Issue 4
Abstract
Background: Chronic Kidney Disease (CKD) and Cardiovascular Disease (CVD) have been inextricably linked since the earliest days of hemodialysis. Several statistics accrued since that time attests to the impact of cardiovascular disease in renal patients. Approximately one-half of all deaths in end-stage renal disease patients are attributable to cardiovascular disease, a proportion that is remarkably similar throughout the world. The aim of the study: To Evaluate latent systolic dysfunction and its relation with diastolic dysfunction in hemodialysis patients with normal ejection fraction, using Doppler-derived systolic time intervals. Materials and methods: This retrospective study was conducted in the Department of General Medicine, Government Mohan Kumaramangalam Medical College, Salem in 2017. Patients with systolicand diastolic blood pressures above 140 and 90 mmHg were grouped as hypertensive. According to this classification, 44% of patients were hypertensive. The control group comprised of healthy normotensive persons with no cardiovascular complaints, normal electrocardiogram (ECG) and normal blood chemistries. Results: In our study, 90% of patients with systolic dysfunction had normal IVRT and 84.4% of patients with diastolic dysfunction had normal STI index. However, as in the previous study, the impaired STI index, and prolonged IVRT are independent of the presence of hypertension or left ventricular hypertrophy and IVRT was more sensitive than E/A ratio to diagnose diastolic dysfunction. Conclusion: The most common features of uremic cardiomyopathy namely left ventricular hypertrophy, diastolic dysfunction and systolic dysfunction were present in 40%, 24%, and 40% of our hemodialysis patients respectively. The diastolic dysfunction and latent systolic dysfunction (STI>0.4) were randomly distributed. Impaired STI index and prolonged Isovolumetric relaxation time are independent of the presence of hypertension or left ventricular hypertrophy.
Authors and Affiliations
R Karthikeyan, V Ramkumar
Keywords
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