Key result
High ultrafiltration rate during hemodialysis was associated with increased right ventricular mechanical dispersion.
Why the study?
Does a high ultrafiltration rate increase right ventricular mechanical dyssynchrony in patients undergoing hemodialysis?
Cross-Sectional (n=65)
No
Does a high ultrafiltration rate increase right ventricular mechanical dyssynchrony in patients undergoing hemodialysis?
High ultrafiltration rates during hemodialysis are associated with increased right ventricular mechanical dyssynchrony and decreased global longitudinal strain, suggesting ultrafiltration should be minimized to preserve cardiac mechanics.
Answers are grounded in this paper and cite their sources.
High ultrafiltration rates were associated with increased RV mechanical dispersion after hemodialysis; leaves open whether minimizing rates preserves strain.
OBJECTIVE: Ultrafiltration rate is one of the major determinants of adverse outcomes in patients undergoing hemodialysis (HD) therapy. Previous studies have focused on the impact of HD on right ventricular (RV) peak strain values. However, the influence of HD on the temporal characteristics of deformation has not been reported yet. The aim of the present study was to evaluate the impact of high ultrafiltration rate (HUR) on RV mechanical dyssynchrony. METHODS: Echocardiographic images focused on the RV and left ventricle (LV) were obtained from 60 patients (49.2+-17.3 years, 22 female) before and after HD. Patients were divided into two groups according to ultrafiltration rate. Changes in echocardiographic parameters with HD were examined. Two-dimensional speckle-tracking strain analysis was used to assess deformation. Mechanical dispersion was measured as the standard deviation of time to peak longitudinal strain of six segments for RV and 18 segments for LV. RESULTS: The average ultrafiltrated volume and ultrafiltration rate were 3000.1+-1007.9 mL and 11.4+-2.9 mL/kg/h, respectively. Global longitudinal strain (GLS) of the RV and LV decreased after HD in both groups. A significant difference was observed in RV mechanical dispersion with HD for patients in the high ultrafiltration group. A mild statistically insignificant increase in LV mechanical dispersion was also observed after HD. CONCLUSION: HUR has a substantial impact on LV and RV GLS and RV dyssynchrony. Ultrafiltration rates and volumes should be kept as low as possible to achieve hemodynamic stability and tolerability.
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Serkan Ünlü (2019) conducted a cross-sectional in End-stage kidney disease undergoing hemodialysis (n=65). High ultrafiltration rate (>13 mL/kg/h) vs. Acceptable ultrafiltration rate (≤13 mL/kg/h) was evaluated on Right ventricular mechanical dispersion after hemodialysis (r=0.721, p=0.001). High ultrafiltration rate during hemodialysis was associated with increased right ventricular mechanical dispersion.
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