Comparison of left ventricular subclinical systolic dysfunction between hemodialysis patients and renal transplant recipients using real time three‐dimensional echocardiography

AIMS: The relationship between chronic kidney disease and development of heart failure is a well-known clinical entity. Systolic dyssynchrony index (SDI₁6) is a new diagnostic tool for detection of subclinical left ventricular (LV) systolic dysfunction by using three-dimensional echocardiography (3DE). We aimed to investigate this parameter in patients with end-stage renal disease who were receiving hemodialysis and patients with renal transplant compared to healthy control subjects. MATERIAL AND METHODS: Forty-five hemodialysis patients, 45 patients with renal transplant and 45 age-sex matched healthy control subjects included in the study. All participants were evaluated with 3DE in the interdialytic phase for measurement of LV volumes, ejection fraction and SDI₁6 parameter. RESULTS: Both LV diastolic and systolic volumes were significantly higher in hemodialysis group compared to renal transplant group and healthy controls, but this finding did not translate to a statistically significant difference for LVEF measurements between groups (58. 71 ± 3. 53 vs. 57. 17 ± 2. 97 vs. 59. 23 ± 3. 26, p =. 16 for renal transplant and hemodialysis and healthy control groups, respectively). Mean value of SDI₁6 parameters was significantly higher in hemodialysis group compared to renal transplant group (7. 93 ± 2. 50 vs. 3. 72 ± 1. 71, p <. 001) and healthy controls (7. 93 ± 2. 50 vs. 3. 00 ±. 99, p <. 001) ; whereas, it was similar between renal transplant group and control subjects (3. 72 ± 1. 71 vs. 3. 00 ±. 99, p =. 10). CONCLUSION: SDI₁6 was significantly higher in hemodialysis patients compared to patients with renal transplant and healthy controls.