title: Right ventricular dysfunction in patients with end-stage renal disease.
abstract: BACKGROUND
  While chronic dialysis treatment has been suggested to increase pulmonary pressure values, right ventricular dysfunction (RVD) is a major cause of death in patients with end-stage renal disease. We investigated the impact of different dialysis treatments on right ventricular function.
  
  
  METHODS
  We examined 220 subjects grouped as follows: healthy controls (n = 100), peritoneal dialysis (PD; n = 26), hemodialysis (HD) with radial arteriovenous fistula (AVF; n = 62), and HD with brachial AVF (n = 32). Echocardiography including tissue Doppler imaging (TDI) of the right ventricle was performed in all patients.
  
  
  RESULTS
  Pulmonary pressure values progressively rose from controls across the 3 dialysis groups (21.7 ± 6.8, 29.7 ± 6.7, 37.9 ± 6.7 and 40.8 ± 6.6 mm Hg, respectively; p < 0.001). TDI indices of right ventricular function were more impaired in HD patients, particularly in those with brachial AVF. RVD, assessed by TDI myocardial performance index, was higher in HD patients compared with PD patients (71.3 vs. 34.6%, p < 0.001). Moreover, the prevalence of RVD further increased in patients with brachial AVF compared with the radial access (90.6 vs. 61.3%, p < 0.001).
  
  
  CONCLUSIONS
  Compared to DP, HD increases the risk of RVD, particularly in the presence of brachial AVF. TDI may detect early functional failure of the right ventricle in HD patients.
authors.affiliation: Division of Cardiology, 2nd Faculty of Medicine, University of Rome 'Sapienza', Sant'Andrea Hospital, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Paneni
authors.forename: Mario
authors.initials: M
authors.lastname: Gregori
authors.forename: Giuseppino Massimo
authors.initials: GM
authors.lastname: Ciavarella
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Sciarretta
authors.forename: Luciano
authors.initials: L
authors.lastname: De Biase
authors.forename: Laura
authors.initials: L
authors.lastname: Marino
authors.forename: Giuliano
authors.initials: G
authors.lastname: Tocci
authors.forename: Francesco
authors.initials: F
authors.lastname: Principe
authors.forename: Alessandro
authors.initials: A
authors.lastname: Domenici
authors.forename: Remo
authors.initials: R
authors.lastname: Luciani
authors.forename: Giorgio
authors.initials: G
authors.lastname: Punzo
authors.forename: Paolo
authors.initials: P
authors.lastname: Menè
authors.forename: Massimo
authors.initials: M
authors.lastname: Volpe
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D001916:Brachial Artery / Q000601:surgery; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000453:epidemiology; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D015995:Prevalence; D017534:Radial Artery / Q000601:surgery; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*