title: Comparing right ventricular function and pulmonary artery pressure before and shortly after hemodialysis in patients with end-stage renal disease.
abstract: BACKGROUND
  Early screening and diagnosis of right ventricular (RV) dysfunction and pulmonary artery hypertension is vital in patients with end-stage renal disease (ESRD) because of its relation to patients' survival. The present study is aimed to address and compare RV function parameters and pulmonary artery pressure (PAP) before and shortly after hemodialysis in patients with ESRD.
  
  
  METHODS
  This quasi-experimental study performed at Alzahra Hospital in Isfahan in 2014, 40 consecutive patients with ESRD that referred to hemodialysis ward were assessed by M-mode echocardiography and tissue Doppler imaging before and 30 min after completing hemodialysis to assess RV function parameters and PAP.
  
  
  RESULTS
  Following hemodialysis, mean body weight, both systolic, and diastolic blood pressures (BPs) and also mean systolic PAP significantly decreased, while tricuspid annulus plane systolic excursion (TAPSE), RV fractional area change (RVFAC) significantly increased 30 min after hemodialysis compared with before this procedure. However, systolic myocardial remained unchanged. Changes in body weight after dialysis was adversely associated with patients' age and duration of dialysis. Moreover, change in PAP was positively associated with the level of serum creatinine.
  
  
  CONCLUSIONS
  Early reduction in body weight and BP, as well as improvement in RV function, and PAP is predictable shortly after starting hemodialysis in patients with ESRD. We found that RVFAC and TAPSE values were dependent on preload, but RV S' velocity was load independent. Change in body weight is predicted more in older patients and those who undergoing prolonged hemodialysis. Change in PAP is strongly affected by the severity of renal failure, but RV function may not be influenced by age or duration of dialysis.
authors.affiliation: Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Najafian
authors.affiliation: Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Taheri
authors.affiliation: Department of Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Behzad
authors.initials: B
authors.lastname: Mahaki
authors.affiliation: Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran.
authors.forename: Safieh
authors.initials: S
authors.lastname: Molavi
authors.affiliation: Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran.
authors.forename: Samaneh
authors.initials: S
authors.lastname: Alami
authors.affiliation: Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran.
authors.forename: Somayeh
authors.initials: S
authors.lastname: Khalesi
authors.affiliation: Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran.
authors.forename: Asma
authors.initials: A
authors.lastname: Salehi
keywords: End-stage renal disease; hemodialysis; pulmonary artery pressure; right ventricular function