title: Left ventricular mechanical dyssynchrony in patients with different stages of chronic kidney disease and the effects of hemodialysis.
abstract: Left ventricular (LV) dyssynchrony is a known cause of mortality in patients with heart failure and may possibly play a similar role in patients with chronic kidney disease (CKD) in whom sudden death is one of the most common and as yet not fully explained cause of death. LV synchronicity and its relationship with increased volume load and various biomarkers was analyzed in 145 patients including 53 patients with CKD stages 3 and 4 and in 92 CKD stage 5 patients undergoing hemodialysis (HD) or peritoneal dialysis (PD) using color tissue Doppler imaging and tissue synchronization imaging. The HD patients were evaluated both before and after a single HD session. LV dyssynchrony was defined as a regional difference in time to peak systolic myocardial velocity, between 12 LV segments > 105 milliseconds. LV dyssynchrony was present in 54% of the patients with no difference between CKD 3 and 4 (58%), HD (48%), and PD (51%). LV dyssynchrony was independently associated with LV mass index and increased estimation of LV end-diastolic pressure. A single HD session resulted in significant changes in LV synchronicity variables-with improvement in 50% of the patients-especially in patients with higher myocardial systolic velocities and lower LV mass index. Abnormalities in LV synchronicity are highly prevalent in CKD patients already prior to dialysis treatment and are associated with LV hypertrophy, LV dysfunction and load conditions, underlining the importance of volume status for LV synchronicity in CKD patients.
authors.affiliation: Department of Medical Engineering, School of Technology and Health, Royal Institute of Technology, Stockholm, Sweden.
authors.forename: Shirley Yumi
authors.initials: SY
authors.lastname: Hayashi
authors.forename: Jacek
authors.initials: J
authors.lastname: Nowak
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.forename: Marcelo Mazza do
authors.initials: MM
authors.lastname: Nascimento
authors.forename: Britta
authors.initials: B
authors.lastname: Lind
authors.forename: Anna
authors.initials: A
authors.lastname: Bjällmark
authors.forename: Matilda
authors.initials: M
authors.lastname: Larsson
authors.forename: Maria Aparecida
authors.initials: MA
authors.lastname: Pachaly
authors.forename: Astrid
authors.initials: A
authors.lastname: Seeberger
authors.forename: Miguel C
authors.initials: MC
authors.lastname: Riella
authors.forename: Lars-Åke
authors.initials: LÅ
authors.lastname: Brodin
mesh_terms: D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*