Does preload reduction by hemodialysis affect left ventricular peak systolic longitudinal strain in patients with end-stage renal disease?
Preload reduction via hemodialysis significantly decreases left ventricular peak systolic longitudinal strain, indicating that loading conditions must be considered when interpreting this echocardiographic parameter in ESRD patients.
BACKGROUND: Peak systolic longitudinal strain (PSLS) obtained using the 2D speckle tracking method is a novel indicator of the long-axis function of the left ventricle (LV). We used the 2D strain profile to examine the effect of preload reduction by hemodialysis (HD) on LV PSLS in patients with end-stage renal disease (ESRD). METHOD AND RESULTS: Twenty-nine pairs of echocardiographic evaluations were obtained before and after dialysis. Global LV PSLS was -18.4 +/- 2.9%, at baseline and decreased to -16.9 +/- 3.2% after HD (P < 0.001). Segmental analysis showed that the decrease in PSLS after dialysis was most prominent in mid-LV segments (-17.1 +/- 3.5% vs. -15.4 +/- 3.4%, P < 0.001). CONCLUSION: PSLS obtained from the 2D strain profile is a reliable parameter that may be useful for evaluating LV systolic long-axis function. However, PSLS should be applied cautiously in ESRD patients because it could be affected by dialysis.
Choi et al. (Mon,) studied this question.