Key result
In 32 ESRD patients, Tissue Doppler imaging with a preload increase maneuver accurately identified diastolic dysfunction when performed in euvolemic patients after hemodialysis.
Why the study?
Does a preload increase maneuver combined with Tissue Doppler Imaging improve the accuracy of assessing left ventricular diastolic function in ESRD patients on hemodialysis?
Observational (n=32)
Does a preload increase maneuver combined with Tissue Doppler Imaging improve the accuracy of assessing left ventricular diastolic function in ESRD patients on hemodialysis?
TDI combined with a preload increase maneuver in euvolemic ESRD patients after hemodialysis provides a more accurate assessment of left ventricular diastolic function.
Answers are grounded in this paper and cite their sources.
May enhance TDI accuracy for diastolic assessment in hemodialysis; hypothesis-generating pending larger outcome studies.
OBJECTIVE: Tissue Doppler imaging (TDI) has recently been proposed as a relatively preload-independent method to evaluate left ventricular diastolic function. We sought to investigate the higher-accuracy of TDI to assess diastolic function in end-stage renal disease (ESRD) patients on hemodialysis (HD) associated with a preload increase maneuver. METHODS: Thirty-two consecutiveESRD patients (16 female, ages 48.8 +/- 17.5 years, 14 <or=45 and 18 >45 years old) were evaluated. Measurements of E, A velocities and the E/A ratio from transmitral inflow pulsed wave Doppler, and E', A' velocities and the E'/A' ratio from TDI were obtained 1 h before and 1 h after HD at baseline and with a preload increase maneuver. RESULTS: The E/A ratio changed significantly in all patients aged >45 before and after HD with the preload increase maneuver. The E'/A' ratio increased in all subjects with the preload increase maneuver before HD but did not change with the maneuver after HD in the euvolemic state in all patients. CONCLUSION: In ESRD patients on routine HD, TDI evaluation associated with a preload increase maneuver proved to be a more accurate method to identify diastolic dysfunction when the evaluation is performed in euvolemic patients after HD.
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Freitas et al. (2006) conducted an observational in End-stage renal disease (ESRD) on hemodialysis (n=32). Preload increase maneuver during Tissue Doppler imaging vs. Baseline (without maneuver) was evaluated on E'/A' ratio from Tissue Doppler imaging. In 32 ESRD patients, Tissue Doppler imaging with a preload increase maneuver accurately identified diastolic dysfunction when performed in euvolemic patients after hemodialysis.
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