الفهرس | Only 14 pages are availabe for public view |
Abstract Chronic kidney disease (CKD) is a global problem, gaining importance day after another. CKD burden increases due to increased prevalence of hypertension, diabetes Mellitus, and cardiovascular diseases. CVDs are the major cause of death in hemodialysis patients accounting for up to 45% of all deaths. Speckle-tracking echocardiography has emerged as a quantitative technique for evaluating myocardial function. The present study aimed at assessing the right ventricular functions in chronic hemodialysis patients using two-dimensional speckle tracking echocardiography as a noninvasive and quantitative method of assessment. This study included 100 patients with chronic hemodialysis patients (group I) referred to the cardiology department, Benha University Hospital and were compared with 20 healthy individuals (group II) of matched age and gender. They were assessed for baseline characteristics, admission data, electrocardiography and echocardiographic parameters. Patients with hemodialysis had greater RA volumes (maximal and minimal), greater RV areas (end systolic and end diastolic), volumes (end systolic and end diastolic) and greater estimated pulmonary artery systolic pressure(PASP) but lower RV fractional area change (FAC) and lower tricuspid annular plane excursion (TAPSE). There was no significant statistical difference between the 2 groups regarding left ventricular ejection fraction, Left ventricular end Summary 93 diastolic volume (LVEDV), left ventricular end systolic volume (LVESV). Right ventricular and atrial global longitudinal strain (RAGLS% and RVGLS %) were significantly reduced in hemodialysis patients. Right ventricular global longitudinal strain (RVLS) showed a significant negative correlation with age, RV end-diastolic and end systolic volumes, RV diameters (longitudinal diameter and mid cavity diameter), RA maximal volume and tricuspid E∕A ratio. While it showed significant positive correlation with FAC and LV ejection fraction. Tricuspid valve E wave velocity and tricuspid E/A ratio were significantly decreased in group I patients. While tricuspid valve A wave velocity was significantly increased in group I patients. Tricuspid valve E\ and S velocity were significantly decreased in group I patients while tricuspid valve A\ velocity was significantly increased in group I patients. MPI was significantly increased in group I patients. Right atrial global longitudinal strain (RALS) showed a significant negative correlation with RA maximal volume and positive correlation with RV end diastolic area and RA transverse diameter. |