title: Myocardial fibrosis and diastolic dysfunction in patients on chronic haemodialysis.
abstract: BACKGROUND
  Left ventricular (LV) diastolic dysfunction is linked to myocardial collagen content in many cardiac diseases. There are no data regarding such relationship in patients with end-stage renal disease (ESRD) undergoing haemodialysis.
  
  
  METHODS
  Twenty-five patients with ESRD undergoing haemodialysis were studied by echocardiography. LV diastolic function was investigated by Doppler echocardiography, by analysing LV filling velocities at rest and during loading manoeuvres, which represent an estimate of LV filling pressure. According to the Doppler pattern, LV filling pressure in a given patient was judged to be normal or slightly increased or to be moderately or severely increased. The presence of myocardial fibrosis was estimated by ultrasound tissue characterization with integrated backscatter, which in diastole correlates with the collagen content of the myocardium.
  
  
  RESULTS
  Integrated backscatter was higher in patients with moderate or severely increased than in patients with normal or slightly increased LV filling pressure (integrated backscatter: 51.0 +/- 9.8 vs 41.6 +/- 5.6%; P = 0.008). Integrated backscatter was a strong and independent determinant of diastolic dysfunction (odds ratio = 1.212; P = 0.040).
  
  
  CONCLUSIONS
  Our data support the hypothesis that, in a selected population of patients with ESRD undergoing haemodialysis, myocardial fibrosis is associated with LV diastolic myocardial properties.
authors.affiliation: Department of Clinical Medicine, Cardiovascular & Immunological Sciences, Federico II University School of Medicine, Naples, Italy. losi@unina.it
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Losi
authors.forename: Bruno
authors.initials: B
authors.lastname: Memoli
authors.forename: Carla
authors.initials: C
authors.lastname: Contaldi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barbati
authors.forename: Marco
authors.initials: M
authors.lastname: Del Prete
authors.forename: Sandro
authors.initials: S
authors.lastname: Betocchi
authors.forename: Massimo
authors.initials: M
authors.lastname: Cavallaro
authors.forename: Gerardo
authors.initials: G
authors.lastname: Carpinella
authors.forename: Angelica
authors.initials: A
authors.lastname: Fundaliotis
authors.forename: Lucia-S
authors.initials: LS
authors.lastname: Parrella
authors.forename: Valentina
authors.initials: V
authors.lastname: Parisi
authors.forename: Bruna
authors.initials: B
authors.lastname: Guida
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiariello
mesh_terms: D000328:Adult; D000368:Aged; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D005355:Fibrosis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D006435:Renal Dialysis; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D055815:Young Adult