title: Acute Haemodialysis-induced Changes in Tissue Doppler Echocardiography Parameters.
abstract: BACKGROUND
  Tissue Doppler imaging (TDI) is a method that determines the tissue motion and velocity within the myocardium.
  
  
  OBJECTIVE
  To characterize acute haemodialysis (HD)-induced changes in TDI-derived indices for patients that have end-stage renal disease (ESRD).
  
  
  METHODS
  Cross sectional study.
  
  
  METHODS
  Conventional echocardiography and TDI methods were applied to study ESRD patients (n=58) before and after HD. Pulmonary venous flow, mitral inflow, and TDI signals of the lateral and septal mitral annulus were examined for the determination of altered left-ventricular diastolic filling parameters. Flow velocities from early- (E) and late-atrial (A) peak transmitral; peak pulmonary vein systolic (S) and diastolic (D); and myocardial peak systolic (Sm) and peak early (Em) and late (Am) diastolic mitral annular velocities were also assessed for changes.
  
  
  RESULTS
  Transmitral E and A velocities and the E/A ratio decreased significantly after HD (p<0.001). Pulmonary vein S (p<0.001) and D (p<0.001) velocities decreased, and S/D ratios increased significantly (p=0.027). HD led to a reduction in septal Em (p<0.001), lateral Em (p=0.006), and Am (p<0.001) velocities. Contrary to the decreases in Em and Am, the Em/Am ratio remained unchanged.
  
  
  CONCLUSIONS
  A single HD session was associated with an acute deterioration in the diastolic parameters. Since the Em/Am ratio remained unchanged, we conclude that this index is a relatively load-independent measure of diastolic function in HD patients.
authors.affiliation: Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Saim
authors.initials: S
authors.lastname: Sağ
authors.affiliation: Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Yeşilbursa
authors.affiliation: Department of Nephrology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Abdulmecit
authors.initials: A
authors.lastname: Yıldız
authors.affiliation: Department of Nephrology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Dilek
authors.affiliation: Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Tunay
authors.initials: T
authors.lastname: Sentürk
authors.affiliation: Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Osman Akın
authors.initials: OA
authors.lastname: Serdar
authors.affiliation: Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Aydınlar
keywords: Echocardiography; haemodialysis; left ventricular systolic and diastolic function; tissue Doppler imaging