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The Impact of left ventricular preload reduction on cardiac pulsed doppler indices during hemodialysis and its relation to intra-dialysis hypotension : a pulsed doppler study
المؤلفون المشاركون
Garadah, Taysir Sayyid
al-Awadi, Abd al-Hayy Ali
al-Arid, Samir
المصدر
Saudi Journal of Kidney Diseases and Transplantation
العدد
المجلد 20، العدد 2 (30 إبريل/نيسان 2009)، ص ص. 201-207، 7ص.
الناشر
تاريخ النشر
2009-04-30
دولة النشر
السعودية
عدد الصفحات
7
التخصصات الرئيسية
الموضوعات
- القلب
- البطين الأيسر
- اضطرابات الدورة الدموية
- غسيل الكلى
- انخفاض ضغط الدم
- المضاعفات(الطب)
- تخطيط صدى القلب الدوبلري
الملخص EN
Fluid status in the body plays an important role on left ventricular (LV) filling in patients with end-stage renal disease (ESRD) on regular hemodialysis (HD), and plays a role in intra-dialysis hemodynamic derangement.
Fifty-two patients with ESRD on regular HD, including 34 males with a mean age of 45.5 ± 13 years (range 18-72 years), were studied.
All patients underwent Echo-pulsed Doppler study before and immediately after a HD session.
The Echo Doppler indices noted were : LV cavity dimension and wall thickness, LV ejection fraction (LVEF%), trans-mitral early diastolic filling velocity (E wave), atrial filling diastolic velocity (A wave), E/A ratio, Deceleration Time (DT) of E wave, Isovolumic relaxation time (IVRT), Aortic Velocity Integral (AVI) and Inferior Vena Cava Diameter (VCD) at expiration.
Patients were divided into two groups according to the amount of net ultra filtrate loss after HD.
Group I comprised of 25 patients with fluid loss of < 2 liters, and Group II had 27 patients with fluid loss > 2 liters.
During the HD session, each patient was observed for the development of acute clinical events such as arterial hypotension (systolic BP less than 90 mmHg), chest pain and arrhythmias.
There was a significant difference between the two groups in the mean values, pre- and post- HD, of reduction of E wave velocity (p< 0.01), the reduction of E / A ratio (p< 0.05), the increment in DT of E wave (p< 0.05), the reduction in AVI (p< 0.01) and the reduction of VCD (p< 0.05).
There was no significant difference between the groups in the reduction of A wave velocity and the reduction of IVRT.
Among the study patients, 11 (21%) developed systolic hypotension during HD.
The pre-dialysis mean values of E / A ratio and DT of E wave in patients who developed hypotension compared to those who did not was 0.7 ± 0.2 vs 1.1 ± 0.2.1 (p< 0.001) and 246 ± 40 vs 224 ± 34 msec (p< 0.05), respectively.
Our study suggests that preload reduction in patients with ESRD on regular HD is directly proportional to the reduction of left ventricle early filling and prolongation of Deceleration Time of E wave.
The potential risk of intra-dialysis hypotension can be predicted, if LV diastolic Pulse Doppler predialysis E/A ratio is less than 0.7 and Deceleration Time of E wave is more than 246 msec.
Careful assessment of these patients is crucial to prevent hypotension, especially if a large preload reduction is required.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
al-Arid, Samir& Garadah, Taysir Sayyid& al-Awadi, Abd al-Hayy Ali. 2009. The Impact of left ventricular preload reduction on cardiac pulsed doppler indices during hemodialysis and its relation to intra-dialysis hypotension : a pulsed doppler study. Saudi Journal of Kidney Diseases and Transplantation،Vol. 20, no. 2, pp.201-207.
https://search.emarefa.net/detail/BIM-36367
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
al-Arid, Samir…[et al.]. The Impact of left ventricular preload reduction on cardiac pulsed doppler indices during hemodialysis and its relation to intra-dialysis hypotension : a pulsed doppler study. Saudi Journal of Kidney Diseases and Transplantation Vol. 20, no. 2 (Mar. 2009), pp.201-207.
https://search.emarefa.net/detail/BIM-36367
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
al-Arid, Samir& Garadah, Taysir Sayyid& al-Awadi, Abd al-Hayy Ali. The Impact of left ventricular preload reduction on cardiac pulsed doppler indices during hemodialysis and its relation to intra-dialysis hypotension : a pulsed doppler study. Saudi Journal of Kidney Diseases and Transplantation. 2009. Vol. 20, no. 2, pp.201-207.
https://search.emarefa.net/detail/BIM-36367
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references : p. 207
رقم السجل
BIM-36367
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
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