Sarafidis P et al. – This study evaluated the LV (left ventricle) and RV (right ventricle) functional changes during the first and a standard weekly hemodialysis and to examine the possible effect of acute intradialytic volume changes in LV and RV diastolic function and pulmonary circulation loading. The authors concluded that hemodialysis decreases the LV and RV diastolic function and improves pulmonary circulation loading and increase in intradialytic volume removal may affect cardiac diastolic function.

Methods

• Patients receiving standard thrice–weekly hemodialysis (n=41) were included in the study.
• Two–dimensional echocardiographic and tissue Doppler imaging (TDI) studies were performed with a standard cardiac ultrasound device shortly before and after the first weekly and a standard dialysis session.
• Effect of volume changes on peak early mitral (E) and tricuspid (E RV) velocities changes were assessed using multiple linear regression analysis

Results

• Left and right atrial, LV and RV sizing echocardiographic parameters were decreased ,post–haemodialysis.
• No changes were observed in the LV systolic function, represented by LV ejection fraction, cardiac output and mean peak systolic LV and RV velocities at the annulus levels.
• There is a decrease in TDI peak early mitral (E') velocity and E'/A'; RV ratio after haemodialysis and improvement was shown in Pulmonary circulation loading.
• Intradialytic weight loss was independently associated with changes in E and E RV according to the multiple regression model analysis.