Conversion to in-centre nocturnal haemodialysis significantly improved global circumferential strain (P=0.025) and decreased torsion compared to conventional haemodialysis over 52 weeks.
Cohort (n=67)
Yes
Does conversion to in-centre nocturnal haemodialysis improve global left ventricular strain and torsion in patients on conventional haemodialysis?
Intensified in-centre nocturnal haemodialysis is associated with improvements in left ventricular global circumferential strain and torsion, suggesting favorable effects on cardiac structure and function.
p-value: p=0.025
AIM: Intensified haemodialysis is associated with regression of left ventricular (LV) mass. Compared to LV ejection fraction, LV strain allows more direct assessment of LV function. We sought to assess the impact of in-centre nocturnal haemodialysis (INHD) on global LV strain (radial, circumferential, and longitudinal) and torsion by cardiac MRI (CMR). METHODS: In this prospective, two-centre cohort study, 37 participants on conventional haemodialysis (CHD, 3-4 h/session for three sessions/week) converted to INHD (7-8 h/session for three sessions/week) and 30 participants continued CHD. Participants underwent CMR using a standardized protocol and had biomarker measurements at baseline and 52 weeks. RESULTS: Among the 55 participants (mean age 55; 40% women) with complete CMR data, those who converted to INHD had a significant improvement in their global circumferential strain (GCS, P = 0.025), while those continuing CHD did not have any significant changes in LV strain. When the two groups were compared, there was significant improvement in torsion. LV strains were significantly correlated with each other, but not with troponin I, C-reactive protein, or brain natriuretic protein (NT-proBNP), except for global longitudinal strain (GLS) with troponin I (P = 0.001) and NT-proBNP (P = 0.038). CONCLUSION: Conversion to INHD was associated with significant improvement in GCS over one year of study, although comparisons with the CHD group were not significant. There was also a significant decrease in torsion in the INHD group compared with CHD. Improvement in LV regional function would support the notion that INHD has favourable effects on both LV structure and function.
Ong et al. (Tue,) conducted a cohort in Haemodialysis (n=67). In-centre nocturnal haemodialysis (INHD) vs. Conventional haemodialysis (CHD, 3-4 h/session for three sessions/week) was evaluated on Global LV strain (radial, circumferential, and longitudinal) and torsion by cardiac MRI (p=0.025). Conversion to in-centre nocturnal haemodialysis significantly improved global circumferential strain (P=0.025) and decreased torsion compared to conventional haemodialysis over 52 weeks.