Cardiac remodeling and right ventricular function in patients with end-stage renal disease one year since maintenance hemodialysis initiation

Abstract

Introduction. Due to the increasing number of patients requiring renal replacement therapy and bidirectional interactions between kidneys and heart, known as reno-cardiac syndrome, the assessment of dialysis influence on heart performance has become paramount.
Material and methods. This was a prospective study analyzing data of 22 adult patients with end-stage renal disease, referred for maintenance hemodialysis (HD) at our Dialysis Centre between January 2019 and December 2019.
Results. The median age of the patients was 59.5 (51–64) years, and 55% of the study group were females. The most common comorbidities were hypertension (86%) and diabetes (36%). At one-year follow-up, there was a significant decrease in proximal and distal right ventricular outflow tract (RVOT) dimensions (p = 0.04; p = 0.007 respectively) and in isovolumic acceleration time corrected (p = 0.01). As the result of the prolongation of isovolumic relaxation time corrected (p < 0.001) and isovolumic contraction time corrected (p < 0.001) a significant increase in myocardial performance index (MPI) (p < 0.001) was observed.
Conclusions. In patients with end-stage renal disease long-term HD negatively impacts RV function. Isovolumic acceleration and MPI measured with pulsed tissue Doppler are sensitive indicators of changes in RV function.