Abstract
AIMS: Occurrence of heart failure during dialysis treatment is associated with high mortality. However, mechanisms underlying left ventricular dysfunction (LVD) in these patients are still elusive. In patients undergoing haemodialysis, arteriovenous fistula (AVF) is associated with right ventricular dysfunction (RVD) and a further impairment is observed when AVF is brachial rather than radial. However, it is not known whether AVF-induced RVD is associated with an impaired left ventricular function. We studied the relation between right and left ventricular function in 120 patients undergoing either haemodialysis or peritoneal dialysis and 100 healthy age-matched controls. METHODS: Echocardiography including tissue Doppler imaging (TDI) was performed for both ventricles. Average myocardial performance index (MPI) of the right ventricle (RV MPI) was obtained with a multisegmental approach by using TDI. RESULTS: RVD was higher in haemodialysis than peritoneal dialysis patients and a further increase was observed in haemodialysis patients with brachial access. Interestingly, RV MPI inversely correlated with indices of both left ventricular contraction and relaxation and the association was even stronger in haemodialysis patients, particularly in those with brachial AVF. Of note, dialysis patients in the upper tertile of RV MPI showed the larger impairment of left ventricular function. Regression analyses showed that RV MPI was independently associated with reduced left ventricular function. By contrast, LVD did not significantly affect right ventricular performance in this setting. CONCLUSION: AVF-induced RVD may contribute to LVD in dialysis patients. AVF plays a pivotal role in triggering LVD via right-to-left ventricular interdependence.
| Original language | English |
|---|---|
| Pages (from-to) | 289-295 |
| Number of pages | 7 |
| Journal | Journal of Cardiovascular Medicine |
| Volume | 14 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2013 |
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Keywords
- Arteriovenous fistula
- Dialysis
- Heart failure
- Left ventricular function
- Right ventricular function
- Ventricular interdependence
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Relation between right and left ventricular function in patients undergoing chronic dialysis. / Paneni, Francesco; Gregori, Mario; Ciavarella, Giuseppino M.; Sciarretta, Sebastiano; Palano, Francesca; Pignatelli, Giulia; Castello, Lorenzo; Domenici, Alessandro; Punzo, Giorgio; Tocci, Giuliano; De Biase, Luciano; Menè, Paolo; Volpe, Massimo.
In: Journal of Cardiovascular Medicine, Vol. 14, No. 4, 04.2013, p. 289-295.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Relation between right and left ventricular function in patients undergoing chronic dialysis
AU - Paneni, Francesco
AU - Gregori, Mario
AU - Ciavarella, Giuseppino M.
AU - Sciarretta, Sebastiano
AU - Palano, Francesca
AU - Pignatelli, Giulia
AU - Castello, Lorenzo
AU - Domenici, Alessandro
AU - Punzo, Giorgio
AU - Tocci, Giuliano
AU - De Biase, Luciano
AU - Menè, Paolo
AU - Volpe, Massimo
PY - 2013/4
Y1 - 2013/4
N2 - AIMS: Occurrence of heart failure during dialysis treatment is associated with high mortality. However, mechanisms underlying left ventricular dysfunction (LVD) in these patients are still elusive. In patients undergoing haemodialysis, arteriovenous fistula (AVF) is associated with right ventricular dysfunction (RVD) and a further impairment is observed when AVF is brachial rather than radial. However, it is not known whether AVF-induced RVD is associated with an impaired left ventricular function. We studied the relation between right and left ventricular function in 120 patients undergoing either haemodialysis or peritoneal dialysis and 100 healthy age-matched controls. METHODS: Echocardiography including tissue Doppler imaging (TDI) was performed for both ventricles. Average myocardial performance index (MPI) of the right ventricle (RV MPI) was obtained with a multisegmental approach by using TDI. RESULTS: RVD was higher in haemodialysis than peritoneal dialysis patients and a further increase was observed in haemodialysis patients with brachial access. Interestingly, RV MPI inversely correlated with indices of both left ventricular contraction and relaxation and the association was even stronger in haemodialysis patients, particularly in those with brachial AVF. Of note, dialysis patients in the upper tertile of RV MPI showed the larger impairment of left ventricular function. Regression analyses showed that RV MPI was independently associated with reduced left ventricular function. By contrast, LVD did not significantly affect right ventricular performance in this setting. CONCLUSION: AVF-induced RVD may contribute to LVD in dialysis patients. AVF plays a pivotal role in triggering LVD via right-to-left ventricular interdependence.
AB - AIMS: Occurrence of heart failure during dialysis treatment is associated with high mortality. However, mechanisms underlying left ventricular dysfunction (LVD) in these patients are still elusive. In patients undergoing haemodialysis, arteriovenous fistula (AVF) is associated with right ventricular dysfunction (RVD) and a further impairment is observed when AVF is brachial rather than radial. However, it is not known whether AVF-induced RVD is associated with an impaired left ventricular function. We studied the relation between right and left ventricular function in 120 patients undergoing either haemodialysis or peritoneal dialysis and 100 healthy age-matched controls. METHODS: Echocardiography including tissue Doppler imaging (TDI) was performed for both ventricles. Average myocardial performance index (MPI) of the right ventricle (RV MPI) was obtained with a multisegmental approach by using TDI. RESULTS: RVD was higher in haemodialysis than peritoneal dialysis patients and a further increase was observed in haemodialysis patients with brachial access. Interestingly, RV MPI inversely correlated with indices of both left ventricular contraction and relaxation and the association was even stronger in haemodialysis patients, particularly in those with brachial AVF. Of note, dialysis patients in the upper tertile of RV MPI showed the larger impairment of left ventricular function. Regression analyses showed that RV MPI was independently associated with reduced left ventricular function. By contrast, LVD did not significantly affect right ventricular performance in this setting. CONCLUSION: AVF-induced RVD may contribute to LVD in dialysis patients. AVF plays a pivotal role in triggering LVD via right-to-left ventricular interdependence.
KW - Arteriovenous fistula
KW - Dialysis
KW - Heart failure
KW - Left ventricular function
KW - Right ventricular function
KW - Ventricular interdependence
UR - http://www.scopus.com/inward/record.url?scp=84875213390&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84875213390&partnerID=8YFLogxK
U2 - 10.2459/JCM.0b013e32834eacf0
DO - 10.2459/JCM.0b013e32834eacf0
M3 - Article
C2 - 22189817
AN - SCOPUS:84875213390
VL - 14
SP - 289
EP - 295
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 4
ER -