Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Effects of hemodialysis on the cardiovascular system: Quantitative analysis using wave intensity wall analysis and tissue velocity imaging
KTH, School of Technology and Health (STH), Medical Engineering.
KTH, School of Technology and Health (STH), Medical Engineering.ORCID iD: 0000-0002-5795-9867
KTH, School of Technology and Health (STH), Medical Engineering.
Show others and affiliations
2010 (English)In: Heart and Vessels, ISSN 0910-8327, E-ISSN 1615-2573Article in journal (Refereed) Published
Abstract [en]

Cardiovascular disease is the leading cause of death in patients with end stage renal disease (ESRD). The aim of this study was to investigate the changes in cardiovascular function induced by a single session of hemodialysis (HD) by the analysis of cardiovascular dynamics using wave intensity wall analysis (WIWA) and of systolic and diastolic myocardial function using tissue velocity imaging (TVI). Grey-scale cine loops of the left common carotid artery, conventional echocardiography and TVI images of the left ventricle were acquired before and after HD in 45 patients (17 women, mean age 54) with ESRD. The WIWA indexes, W1 preload-adjusted W1, W2 and preload-adjusted W2, and the TVI variables, isovolumic contraction velocity (IVCV), isovolumic contraction time (IVCT), peak systolic velocity (PSV), displacement, isovolumic relaxation velocity (IVRV), isovolumic relaxation time (IVRT), peak early diastolic velocity (E’) and peak late diastolic velocity (A’), were compared before and after HD. The WIWA measurements showed significant increases in W1 (p < 0.05) and preload-adjusted W1 (p < 0.01) after HD. W2 was significantly decreased (p < 0.05) after HD, whereas the change in preload-adjusted W2 was not significant. Systolic velocities, IVCV (p < 0.001) and PSV (p < 0.01), were increased after HD, whereas the AV-plane displacement were decreased (p < 0.01). For the measured diastolic variables, E’ was significantly decreased (p < 0.01) and IVRT was significantly prolonged (p < 0.05), after HD. A few correlations were found between WIWA and TVI variables. The WIWA and TVI measurements indicate that a single session of HD improves systolic function. The load dependency of the diastolic variables seems to be more pronounced than for the systolic variables. Preload-adjusted wave intensity indexes may contribute in the assessment of true LV contractility and relaxation.

Place, publisher, year, edition, pages
2010.
National Category
Medical Laboratory and Measurements Technologies
Identifiers
URN: urn:nbn:se:kth:diva-11755DOI: 10.1007/s00380-010-0050-zISI: 000290540600008PubMedID: 21063879Scopus ID: 2-s2.0-79959734650OAI: oai:DiVA.org:kth-11755DiVA: diva2:280831
Note
Uppdaterad från Manuskript till Artikel (2011208) QC 20100705Available from: 2009-12-11 Created: 2009-12-11 Last updated: 2017-12-12Bibliographically approved
In thesis
1. New ultrasonographic approaches to monitoring cardiac and vascular function
Open this publication in new window or tab >>New ultrasonographic approaches to monitoring cardiac and vascular function
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Atherosclerotic cardiovascular disease is the leading cause of death worldwide. To decrease mortality and morbidity in cardiovascular disease, the development of accurate, non-invasive methods for early diagnosis of atherosclerotic cardiac and vascular engagement is of considerable clinical interest. Cardiovascular ultrasound imaging is today the cornerstone in the routine evaluation of cardiovascular function and recent development has resulted in two new techniques, tissue velocity imaging (TVI) and speckle tracking, which allow objective quantification of cardiovascular function. TVI and speckle tracking are the basis for three new approaches to cardiac and vascular monitoring presented in this thesis: wave intensity wall analysis (WIWA), two-dimensional strain imaging in the common carotid artery, and the state diagram of the heart.

 

WIWA uses longitudinal and radial strain rate as input for calculations of wave intensity in the arterial wall. In this thesis, WIWA was validated against a commercially available wave intensity system, showing that speckle tracking-derived strain variables can be useful in wave intensity analysis. WIWA was further tested in patients with end stage renal disease and documented high mortality in cardiovascular disease. The latter study evaluated the effects of a single session of hemodialysis using WIWA and TVI variables and showed improved systolic function after hemodialysis. The results also indicated that preload-adjusted early systolic wave intensity obtained by the WIWA system may contribute in the assessment of left ventricular contractility in this patient category. Two-dimensional strain imaging in the common carotid artery is a new approach showing great potential to detect age-dependent differences in mechanical properties of the common carotid artery. Among the measured strain variables, global circumferential strain had the best discriminating performance and appeared to be superior to conventional measures of arterial stiffness such as elastic modulus and β stiffness index. The state diagram is a visualisation tool that provides a quantitative overview of the temporal interrelationship of mechanical events in the left and right ventricles. Case examples and a small clinical study showed that state diagrams clearly visualize cardiac function and can be useful in the detection of non ST-elevation myocardial infarction (NSTEMI).

 

Even though WIWA, two-dimensional strain imaging in the common carotid artery and the state diagram show potential to be useful in the evaluation of cardiovascular function, there still remains a considerable amount of work to be done before they can be used in the daily clinical practice.

Place, publisher, year, edition, pages
Stockholm: KTH, 2009. xiv, 47 p.
Series
Trita-STH : report, ISSN 1653-3836 ; 2009:7
National Category
Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:kth:diva-11760 (URN)978-91-7415-525-9 (ISBN)
Public defence
2010-01-22, 3-221, Alfred nobels alle 10, Huddinge, 13:00 (Swedish)
Opponent
Supervisors
Note
QC 20100705Available from: 2009-12-14 Created: 2009-12-11 Last updated: 2010-07-05Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMedScopus

Authority records BETA

Larsson, Matilda

Search in DiVA

By author/editor
Bjällmark, AnnaLarsson, MatildaBrodin, Lars-ÅkeNowak, JacekLind, BrittaHayashi, Shirley
By organisation
Medical Engineering
In the same journal
Heart and Vessels
Medical Laboratory and Measurements Technologies

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 170 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf