title: [Assessment of left ventricular function by midwall fractional shortening in hemodialysis patients].
abstract: OBJECTIVE
  Midwall fractional shortening (MFS) is a useful index to evaluate left ventricular myocardial function in patients with essential hypertension. The study investigated the prevalence and characterization of low MFS in hemodialysis patients.
  
  
  METHODS
  MFS was calculated from M-mode echocardiograms in 67 patients (34 males, 33 females) receiving maintenance hemodialysis in whom fractional shortening was normal. Plasma levels of atrial and brain natriuretic peptides were also measured in these patients before and after hemodialysis. MFS was evaluated by stress-corrected MFS (ratio of observed to predicted MFS). The relationship of MFS to circumferential end-systolic stress in 122 healthy subjects was used to calculate the predicted MFS.
  
  
  RESULTS
  Stress-corrected MFS was depressed in 18 of the 67 patients (26.9%). In the low MFS group, duration of hypertension was significantly longer (p < 0.05), wall thickness was significantly greater (p < 0.001), left ventricular dimension was significantly smaller (p < 0.0001), and relative wall thickness was significantly greater (p < 0.0001) than in the normal MFS group. Reduction of brain natriuretic peptide level by hemodialysis in the low MFS group was significantly higher (p < 0.05) than in the normal MFS group.
  
  
  CONCLUSIONS
  Depression of stress-corrected MFS may be common in hemodialysis patients. Long duration of hypertension and concentric geometry of the left ventricle occur in patients with low MFS.
authors.affiliation: Department of Hypertension and Cardiorenal Medicine, Dokkyo University School of Medicine, Kitakobayashi 880, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293.
authors.forename: Takeaki
authors.initials: T
authors.lastname: Honda
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tamano
authors.forename: Masaki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Uetake
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Seta
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D020097:Natriuretic Peptide, Brain / Q000097:blood; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000503:physiopathology / Q000628:therapy; D016277:Ventricular Function, Left
chemical_list: D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor