Assessment Of Right Ventricular Function Change In Patients With Chronic Renal Failure Before And After Hemodialysis Using Echocardiography

Objective To evaluate the changes of right ventricular volume and myocardial mechanical parameters before and after hemodialysis in patients with chronic renal failure using echocardiography.Methods One hundred patients with clinically diagnosed chronic renal failure underwent hemodialysis were enrolled in the study.Conventional and tissue Doppler(TDI)echocardiography was performed before and after hemodialysis immediately and respectively to measure tricuspid annular plane systolic excursion(TAPSE),right ventricular fractional area change(FAC),the longitudinal two-dimensional right ventricular free wall systolic peak strain(2D RVFWLS),diastolic velocity(e,a)of tricuspid annulus at free wall,systolic peak velocity of tricuspid regurgitation(TRmax)for the differences and the correlation between the above parameters and the amount of ultrafiltration volume.Results The weight of patients was significantly reduced after dialysis[(61.01±9.77)kg after versus(63.04±9.88)kg before,P<0.05].There were no statistically significant difference of systolic and diastolic blood pressures of brachial artery before and after dialysis.There was a significant increment of TAPSE after dialysis compared to that before dialysis [(21.36±2.35)mm after versus(20.23±2.30)mm before,P<0.05].There was no statistically significant changes in FAC(%),2D RVFWLS,e/a(%),TRmax.The brachial artery diastolic blood pressure after dialysis was statistically correlated with ultrafiltration volume(r=0.304,P=0.002).There was no correlation between TAPSE,RVFAC,2DRVFWLS,e/a and TRmax after dialysis to the ultrafiltration volume.Conclusion TAPSE is correlated with the right ventricular volume load(pre-load).The TAPSE after hemodialysis is increased and significantly higher than that before dialysis suggests that hemodialysis could enhance the longitudinal systolic function of right ventricular free wall,but not correlated with the volume of hemodialysis ultrafiltration.The ultrafiltration volume might impact on the brachial artery diastolic blood pressure.