[Evaluation of cardiac function during hemopurification in patients with chronic renal failure].
Evaluation of cardiac function during hemopurification was performed in 26 patients with chronic renal failure. Cardiac function was measured with a Swan-Ganz thermodilution catheter prior to and every hour after starting the procedure. The effects of hemodialysis (HD) and hemofiltration (HF) on cardiac function were compared by crossover study. The variation in the left ventricular stroke work index (SWI) associated with the reduction in the pulmonary capillary wedge pressure (PCWP) was smaller (p less than 0.05) during HF than during HD. The reduction in PCWP and the variation in SWI associated with the increase in the rate of water elimination were smaller (p less than 0.05) during HF than during HD. These findings suggested that in terms of left ventricular contractility, HF had less effect on cardiac function than did HD. In the second part of the study, 12 diabetic patients (DN group) were compared with 14 non-diabetic (non-DN group) in terms of cardiac function during HD. The rise in the variation in SWI associated with the increase in the variation in the double product tended to be smaller in the DN group than in the non-DN group. The regression coefficient of the variation in the systemic vascular resistance index (SVRI) to the variation in SWI for the DN group was positive, and different (p less than 0.05) from the negative coefficient obtained for the non-DN group. These results suggested that during HD the DN group had less effective utilization of oxygen in cardiac muscle and an impaired compensatory mechanism for decreases in cardiac function associated with increased water elimination than did the non-DN group.
Murasawa
T
T
D000328:Adult; D000368:Aged; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006440:Hemofiltration; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis