title: Myocardial performance index suggests optimal fluid loss during hemodialysis.
abstract: BACKGROUND
  Patients on long-term maintenance hemodialysis (HD) are at high risk of developing cardiovascular disease and suffering various cardiovascular complications during HD.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the influence of changing loading conditions on the myocardial performance index (MPI) in patients on long-term HD and to specify an optimal level of fluid loss during HD that would maintain stable global cardiac function.
  
  
  METHODS
  The study consisted of 52 patients with end-stage renal failure (ESRF), mean age 56±11.7 y, range: 25-80 y, on regular HD. For each patient a complete echocardiographic-Doppler examination was performed before and after HD. Systolic and diastolic parameters of left ventricular function were measured, and the myocardial performance index (MPI) was calculated.
  
  
  RESULTS
  The MPI was significantly prolonged after HD (0.47±0.15 before HD versus 0.59±0.16 after HD, p < 0.001). Mean change in body weight during HD was 2.1±0.86 kg. The MPI did not change significantly in patients with intradialytic weight loss up to 1.75 kg.
  
  
  CONCLUSIONS
  The MPI value seems to be independent of acute preload changes only when fluid loss is less than 1.75 kg. A 1.75-kg fluid loss during HD seems to be the optimal goal. In ESRF patients on HD, the MPI seems to be a good indicator of global left ventricular function and potentially a valuable aid in the effort to maintain optimal fluid balance.
authors.affiliation: Department of Clinical Therapeutics, University of Athens, "Alexandra" Hospital, Greece. elektrapap@yahoo.gr
authors.forename: Elektra S
authors.initials: ES
authors.lastname: Papadopoulou
authors.forename: Savvas T
authors.initials: ST
authors.lastname: Toumanidis
authors.forename: George
authors.initials: G
authors.lastname: Tsirpanlis
authors.forename: Chrisanthi O
authors.initials: CO
authors.lastname: Trika
authors.forename: Garyfalia
authors.initials: G
authors.lastname: Kalatzopoulou
authors.forename: Spyridon D
authors.initials: SD
authors.lastname: Moulopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006115:Greece; D006439:Hemodynamics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D014882:Water-Electrolyte Balance; D015431:Weight Loss