Preprint Article Version 2 This version is not peer-reviewed

Assessment of Left Ventricular Diastolic Function in Children Undegoing Hemodialysis. A Mini Review

Version 1 : Received: 16 November 2018 / Approved: 19 November 2018 / Online: 19 November 2018 (09:22:15 CET)
Version 2 : Received: 4 July 2019 / Approved: 4 July 2019 / Online: 4 July 2019 (10:37:00 CEST)

How to cite: Sulovic, L.; Sulovic, V.; Zivkovic, Z.; Vasic, M.; Sulovic, N.; Filipovic-Danic, S. Assessment of Left Ventricular Diastolic Function in Children Undegoing Hemodialysis. A Mini Review. Preprints 2018, 2018110435 (doi: 10.20944/preprints201811.0435.v2). Sulovic, L.; Sulovic, V.; Zivkovic, Z.; Vasic, M.; Sulovic, N.; Filipovic-Danic, S. Assessment of Left Ventricular Diastolic Function in Children Undegoing Hemodialysis. A Mini Review. Preprints 2018, 2018110435 (doi: 10.20944/preprints201811.0435.v2).

Abstract

Assessment of cardiac function is the leading parameter when evaluating the state of the cardiovascular system of patients undergoing chronic hemodialysis. The aim of the paper: to assess the state of the cardiovascular system of these patients using new sensitive echocardiography and Doppler techniques and thus advance the prevention of cardiovascular disease.Method: Twenty children with end-stage renal insufficiency on chronic hemodialysis and twenty healthy controls underwent echocardiographic monitoring using standard Doppler and tissue Doppler imaging. Structural and functional changes in the left ventricle were evaluated.Results: Patients on hemodialysis had significantly greater left ventricular mass indices compared to the controls (p<0.001). The patients on hemodialysis had preserved systolic function – their fractional shortening, ejection fraction and Sm (systolic myocardial velocity) did not differ significantly compared to the controls (p>0.05). Early diastolic function in children on hemodialysis was also preserved: the E/A and Em/Am ratio did not differ significantly from the control group (p>0.05). Children on hemodialysis exhibited impaired late diastolic function (compliance index), that is, considerably higher E/Em compared to controls (p<0.00). Myocardial Performance Index values showed statistically significant elevation in children on hemodialysis compared to the control group (p<0.001).Conclusion: Tissue Doppler in tandem with conventional Pulsed Doppler can provide additional information on left ventricular filling pressures (E/Em) in children on hemodialysis. It is therefore recommended to perform routine measuring of Em waves and the E/Em ratio, not only in order to evaluate myocardial relaxation and ventricular filling pressures, but primarily to stratify risk and provide a prognosis.

Subject Areas

chronic kidney disease; hemodialysis; cardiovascular disease; echocardiography; child

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