Acute preload reduction from haemodialysis significantly decreased mean left atrial strain (23.89% to 21.88%, P=0.019), but did not affect late diastolic tissue velocity or strain rate.
Observational (n=41)
Does preload reduction via haemodialysis affect left atrial strain and strain rate in patients with end-stage renal disease?
Tissue velocity and strain rate during late diastole are relatively preload-independent parameters for evaluating left atrial contractile function.
Absolute Event Rate: 21.88% vs 23.89%
p-value: p=0.019
AIMS: Both strain and strain rate (SR) measure the regional myocardial deformation and can assess phasic left atrial (LA) function. However, there is still a lack of evidence for their volume independency. In this study, strain and SR determined by tissue Doppler imaging were used to evaluate the effect of preload reduction in end-stage renal disease patients who were undergoing regular haemodialysis (HD). METHODS AND RESULTS: Forty-one subjects who underwent transthoracic echocardiography just before and after HD were enrolled. LA strain was measured during late systole, and LA peak tissue velocity and SR were measured during systole and during early and late diastolic periods. The values of tissue velocity, strain, and SR were obtained in the basal septal, lateral, inferior, and anterior walls of the LA. The mean strain value was 23.89 ± 7.29% at baseline and decreased to 21.88 ± 5.85% after HD (P = 0.019). SR during systole (before HD 1.55 ± 0.40; after HD 1.38 ± 0.35, P = 0.001) and early diastole (before HD -1.41 ± 0.54; after HD -1.16 ± 0.45, P = 0.001) also changed. However, the acute preload change caused by HD did not affect the peak tissue velocity (before HD -6.34 ± 1.58 cm/s; after HD -6.46 ± 1.54 cm/s, P = 0.436) and the SR (before HD -1.36 ± 0.45/s; after HD -1.34 ± 0.29/s, P = 0.621) measured during late diastole. CONCLUSION: Both tissue velocity and SR during late diastole, representing the contractile function of the LA, are relatively preload-independent parameters and are available for the evaluation of the LA function.
Park et al. (2012) conducted an observational in End-stage renal disease (n=41). Haemodialysis (preload reduction) vs. Before haemodialysis was evaluated on Mean left atrial strain (p=0.019). Acute preload reduction from haemodialysis significantly decreased mean left atrial strain (23.89% to 21.88%, P=0.019), but did not affect late diastolic tissue velocity or strain rate.