Key result
In patients with end-stage renal disease receiving hemodialysis, the presence of anemia was associated with significantly worse cardiac mechanics, including impaired left ventricular global longitudinal strain (median -14.6% vs -16.0%, p=0.003).
Why the study?
The study investigated the relationship between anemia and cardiac functions assessed by conventional and speckle-tracking echocardiography in patients with end-stage renal disease receiving hemodialysis.
Cross-Sectional (n=174)
No
Anemia in hemodialysis patients is independently associated with further impairment of left ventricular and left atrial mechanics as detected by speckle-tracking echocardiography.
Anemia-associated strain impairment in hemodialysis patients warrants no practice change; leaves open whether correction improves mechanics or outcomes.
Objective: We investigated the relationship between anemia and cardiac functions by conventional and speckle-tracking echocardiography (STE) in patients with end-stage renal disease (ESRD) receiving hemodialysis. Methods: One hundred six patients with ESRD receiving hemodialysis were included in this cross-sectional study. The conventional echocardiography and STE findings were compared between the patients with and without anemia. In addition, a comparison of the findings between the ESRD patients and healthy controls consisting of 68 participants was conducted. Results: Compared to healthy controls, ESRD patients had lower left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LVGLS), and left atrial reservoir strain (LASr) [53% (48-57) vs. 65% (62-68), -15.2 (-16.9˗ -13.6) vs. -19.7 (-16.9˗ -13.6), and -21.9 (-29.5˗ -15.3) vs. -29.9 (-35.3˗ -22.8), respectively, P-value <0.001 for all]. Of the ESRD patients, 70 (66%) had anemia. ESRD patients with anemia had higher interventricular septum (IVS), posterior wall (PW), and left atrial volume index (LAVi) values than patients without anemia. In addition, ESRD patients with anemia had lower LVEF, LVGLS, and LASr than patients without anemia [median (IQR), 13 (12-15) vs. 12 (11-14), P=0.004, 13 (12-15) vs. 12 (11-13.5), P<0.005, 43 (35-55) vs. 34.7 (28-50), P=0.013, 52 (48-55) vs. 56 (47.5-60), P=0.016, -14.6 (-16.4˗ -13.5) vs. -16 (-18.6˗ -14.7), P=0.003, and -21.6 (-30.5˗ -16.3) vs. -30.5 (-33.6˗ -23.3), P=0.006, respectively]. In multivariable logistic regression analysis, diabetes, PW, LASr, and LVGLS were independently associated with the presence of anemia in ESRD patients. Conclusion: Our study confirmed impaired cardiac mechanics in ESRD hemodialysis patients and showed that anemia was associated with further worsening cardiac mechanics in this population.
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Omar et al. (2023) conducted a cross-sectional in End-stage renal disease (ESRD) receiving hemodialysis (n=174). Anemia vs. Without anemia was evaluated on Left ventricular global longitudinal strain (LVGLS) (p=0.003). In patients with end-stage renal disease receiving hemodialysis, the presence of anemia was associated with significantly worse cardiac mechanics, including impaired left ventricular global longitudinal strain (median -14.6% vs -16.0%, p=0.003).
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