Dataset Information

Long-term impacts of hemodialysis on the right ventricle: Assessment via 3-dimensional speckle-tracking echocardiography.

ABSTRACT: BACKGROUND:Right ventricular (RV) dysfunction is a major cause of death in patients undergoing maintenance hemodialysis (MHD). We used 3-dimensional speckle-tracking echocardiography (3DSTE) to evaluate long-term impacts of MHD on RV function. HYPOTHESIS:In this study, RV dysfunction in MHD patients will be revealed and studied in depth by 3DSTE. METHODS:Echocardiography was performed on 110 consecutively enrolled individuals: 30 controls and 80 patients with MHD. Conventional echocardiographic parameters and 3DSTE parameters were obtained and compared between groups. Univariate and multivariate logistic regression analysis identified independent predictors of intradialytic hypotension (IDH). RESULTS:Compared with the control group, RV end-diastolic volume (RVEDV) was markedly enlarged (46.1?±?11.8?mL/m2 vs 42.3?±?8.6?mL/m2 ; P?=?0.047), whereas RV ejection fraction (RVEF) was significantly lower in the MHD group (50.6%?±?5.8% vs 55.2%?±?3.7%; P?

SUBMITTER: Sun M

PROVIDER: S-EPMC6490018 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Long-term impacts of hemodialysis on the right ventricle: Assessment via 3-dimensional speckle-tracking echocardiography.

Sun Minmin M Cao Xuesen X Guo Yao Y Tan Xiao X Dong Lili L Pan Cuizhen C Shu Xianhong X

Clinical cardiology 20180124 1

<h4>Background</h4>Right ventricular (RV) dysfunction is a major cause of death in patients undergoing maintenance hemodialysis (MHD). We used 3-dimensional speckle-tracking echocardiography (3DSTE) to evaluate long-term impacts of MHD on RV function.<h4>Hypothesis</h4>In this study, RV dysfunction in MHD patients will be revealed and studied in depth by 3DSTE.<h4>Methods</h4>Echocardiography was performed on 110 consecutively enrolled individuals: 30 controls and 80 patients with MHD. Conventio ...[more]

PMID: 29363796

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Project description:BackgroundAnimal studies have shown that shear deformation of myocardial sheets in transmural planes of left ventricular (LV) wall is an important mechanism for systolic wall thickening, and normal and shear strains of the LV free wall differ from those of the interventricular septum (IVS). We sought to test whether these also hold for human hearts.MethodsThirty healthy volunteers (male 23 and female 7, aged 34 ± 6 years) from Outpatient Department of the University of Tokyo Hospital were included. Echocardiographic images were obtained in the left decubitus position using a commercially available system (Aloka SSD-6500, Japan) equipped with a 3.5-MHz transducer. The ECG was recorded simultaneously. The peak systolic radial normal strain (length change), shear strain (angle change) and time to peak systolic radial normal strain were obtained non-invasively by two-dimensional speckle tracking echocardiography.ResultsThe peak systolic radial normal strain in both IVS and LV posterior wall (LVPW) showed a trend to increase progressively from the apical level to the basal level, especially at short axis views, and the peak systolic radial normal strain of LVPW was significantly greater than that of IVS at all three levels. The time to peak systolic radial normal strain was the shortest at the basal IVS, and increased progressively from the base to the apical IVS. It gradually increased from the apical to the basal LVPW in sequence, especially at short axis views. The peak of radial normal strain of LVPW occurred much later than the peak of IVS at all three levels. For IVS, the shear deformation was clockwise at basal level, and counterclockwise at mid and apical levels in LV long-axis view. For LVPW, the shear deformations were all counterclockwise in LV long-axis view and increased slightly from base to the apex. LVPW showed larger shear strains than IVS at all three levels. Bland-Altman analysis shows very good agreement between measurements taken by the same observer and by two independent observers.Conclusion"Myocardial sheets" theory also holds true for intact human LV. Moreover, dyssynchrony exists even in healthy human subjects, which should be considered when evaluating the diseased hearts.

Project description:ObjectivesWe aimed to investigate the association between right ventricular longitudinal strain measured by two-dimensional speckle-tracking echocardiography (2D-STE) and right heart catheterization data in pediatric patients with pulmonary hypertension (PH).MethodsTwo groups were evaluated, each consisting of 58 patients. Group 1, patients with PH; Group 2, normal matched controls. Data were collected from 58 patients with PH who underwent invasive hemodynamic evaluation. Standard transthoracic echocardiographic assessment was performed in all patients under the same circumstances. All patients underwent 2D-STE, and off-line analysis generated right ventricle longitudinal strain (RVLS) and right ventricular free wall strain (RVFW) and collected echocardiographic conventional parameters of right ventricular function, including the control group. The relationship between invasive characteristics and right ventricular function parameters was analyzed.ResultsIn all, 58 PH patients were included in our study. The mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) were strongly correlated with right ventricular free wall strain (RVFW) and right ventricular longitudinal strain (RVLS), moderately correlated with the right ventricle myocardial performance index (Tei index), weakly correlated with the transverse diameter of the right ventricle (RV) and the transverse diameter of the right atrium (RA), and moderately negatively correlated with right ventricular fractional area change (RVFAC). In terms of segments of the right ventricular free wall, the basal segment had the highest correlation coefficient with mPAP and PVR (r = 0.413, 0.523, 0.578, r = 0.421, 0.533, 0.575, p < 0.05, respectively). Tricuspid annular plane systolic excursion (TAPSE), main pulmonary artery diameter (MPA), peak systolic velocity of the right ventricle (RV-S'), and RA area parameters were not associated with mPAP and PVR (p > 0.05).ConclusionsRight ventricular longitudinal strain is a reliable indicator to evaluate right ventricular function in pediatric patients with PH. It can provide valuable reference information for the clinical judgment of the status and severity of the disease in children.

Dataset Information

Long-term impacts of hemodialysis on the right ventricle: Assessment via 3-dimensional speckle-tracking echocardiography.

Publications

Long-term impacts of hemodialysis on the right ventricle: Assessment via 3-dimensional speckle-tracking echocardiography.

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