Early detection of impaired left ventricular function in hemodialysis patients

Introduction Chronic kidney disease (CKD) is a worldwide public health problem associated with increased morbidity and cardiovascular diseases. Purpose Our aim was to investigate left ventricular (LV) myocardial function throughout the cardiac cycle with speckle tracking echocardiography (STE) in end-stage renal disease (ESRD) patients undergoing chronic hemodialysis (HD). Methods The study population consisted of 30 maintenance HD patients. These patients were examined just before and after HD. LV global longitudinal (GLS), circumferential (GCS) and radial (GRS) peak systolic strain was measured with 2D-STE and 3D-STE. BNP levels were measured before and after HD. Results Increased LV mass index (LVMi) and a decreased E/A ratio were found in hemodialysis patients. LV global longitudinal and radial peak systolic strain was decreased in the study group population. Strain values improved in longitudinal and radial directions after HD [pre-HD vs. post-HD; GLS: −16.43 (1.7) vs. −18.49 (1.9) %, P P P  = 0.1]. LVMi was inversely related to pre-HD GLS ( r  = −0.418, P  = 0.02) and post-HD GLS ( r  = −0.406, P  = 0.03). Serum BNP levels were also inversely correlated with pre-HD GLS ( r  = −0.433, P r  = −0.456, P Conclusion STE may be used to identify early abnormalities in patients with ESRD undergoing hemodialysis with preserved LV ejection fraction. HD treatment results in immediate improvement in all strain directions. LV hypertrophy may play a role in the deterioration of LV mechanics in patients with ESRD.