Clinical and echocardiographic factors associated with right ventricular systolic dysfunction in hemodialysis patients
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Background: Chronic kidney disease is a disorder of epidemic proportions that impairs cardiac function. Cardiovascular diseases are the leading cause of death in hemodialysis patients, and the understanding of new nontraditional predictors of mortality could improve their outcomes. Right ventricular systolic dysfunction (RVSD) has recently been recognized as a predictor of cardiovascular death in heart failure and hemodialysis patients. However, the factors contributing to RVSD in hemodialysis patients remain unknown. The aim of this study was to evaluate the clinical and echocardiographic factors associated with RVSD in hemodialysis patients. Methods: A cross-sectional study was conducted in which 100 outpatients with end-stage renal disease on chronic hemodialysis were evaluated. A transthoracic echocardiographic examination was performed at optimal dry weight. Right ventricular systolic function was evaluated using tricuspid annular plane systolic excursion (TAPSE). Clinical and echocardiographic data were recorded for each patient. A multivariate linear logistic regression was created using RVSD (TAPSE <14 mm) as the dependent variable. Results: Fifteen patients with RVSD and 85 patients without RVSD were analyzed. TAPSE had a positive correlation with left ventricular ejection fraction (LVEF) and myocardial relaxation velocity. Independent contributors to RVSD were LVEF (OR 1.14, 95%25 CI 1.05-1.26), left ventricular mass index (OR 1.02, 95%25 CI 1.00-1.04), and myocardial relaxation velocity (OR 1.81, 95%25 CI 1.18-3.19). Conclusions: Echocardiographic factors were significant contributors to RVSD. These measurements could be included as part of the routine workup in all end-stage renal disease patients on hemodialysis. © 2016 S. Karger AG, Basel.
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Chronic kidney disease; Hemodialysis; Right ventricular dysfunction; Tricuspid annular plane systolic excursion adult; Article; cardiovascular parameters; clinical assessment; clinical evaluation; controlled study; cross-sectional study; disease association; dry weight; end stage renal disease; female; heart left ventricle ejection fraction; heart left ventricle mass; heart muscle relaxation; heart right ventricle function; hemodialysis; hemodialysis patient; human; major clinical study; male; outpatient care; priority journal; right ventricular systolic dysfunction; systolic dysfunction; transthoracic echocardiography; tricuspid annular plane systolic excursion; tricuspid valve; velocity
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