Left ventricular mechanical dyssynchrony in patients with different stages of chronic kidney disease and the effects of hemodialysis
2013 (English)In: Hemodialysis International, ISSN 1492-7535, E-ISSN 1542-4758, Vol. 17, no 3, 346-358 p.Article in journal (Refereed) Published
Left ventricular (LV) dyssynchrony is a known cause of mortality in patients with heart failure and may possibly play a similar role in patients with chronic kidney disease (CKD) in whom sudden death is one of the most common and as yet not fully explained cause of death. LV synchronicity and its relationship with increased volume load and various biomarkers was analyzed in 145 patients including 53 patients with CKD stages 3 and 4 and in 92 CKD stage 5 patients undergoing hemodialysis (HD) or peritoneal dialysis (PD) using color tissue Doppler imaging and tissue synchronization imaging. The HD patients were evaluated both before and after a single HD session. LV dyssynchrony was defined as a regional difference in time to peak systolic myocardial velocity, between 12 LV segments>105milliseconds. LV dyssynchrony was present in 54% of the patients with no difference between CKD 3 and 4 (58%), HD (48%), and PD (51%). LV dyssynchrony was independently associated with LV mass index and increased estimation of LV end-diastolic pressure. A single HD session resulted in significant changes in LV synchronicity variableswith improvement in 50% of the patientsespecially in patients with higher myocardial systolic velocities and lower LV mass index. Abnormalities in LV synchronicity are highly prevalent in CKD patients already prior to dialysis treatment and are associated with LV hypertrophy, LV dysfunction and load conditions, underlining the importance of volume status for LV synchronicity in CKD patients.
Place, publisher, year, edition, pages
Wiley-Blackwell, 2013. Vol. 17, no 3, 346-358 p.
Cardiac dyssynchrony, chronic kidney disease, hemodialysis, load, peritoneal dialysis, tissue synchronization imaging
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:kth:diva-124717DOI: 10.1111/hdi.12017ISI: 000320936600004ScopusID: 2-s2.0-84879606869OAI: oai:DiVA.org:kth-124717DiVA: diva2:638251
QC 201307292013-07-292013-07-292013-07-29Bibliographically approved