LEFT-VENTRICULAR FUNCTION IN UREMIA - ECHOCARDIOGRAPHIC AND RADIONUCLIDE ASSESSMENT IN PATIENTS ON MAINTENANCE HEMODIALYSIS

  • 1 January 1985
    • journal article
    • research article
    • Vol. 23  (3) , 125-133
Abstract
Echocardiography and radionuclide ventriculography were performed in 37 uremic patients on maintenance hemodialysis with no apparent coronary artery disease, pericardial effusion, valvular heart disease or heart failure. These noninvasive studies were performed during the interdialytic period (about 18 h after a dialysis). Of our patients 62% had abnormal left ventricular function wtih 1 or more abnormal echocardiographic parameters. The significant abnormalities were enlargement of the left ventricular cavity, a reduction of myocardial contractility and thickening of the left ventricular posterior wall. Similar findings were found in 10 undialyzed uremic patients. Measurement of cardiac index and ejection fraction were inadequate for a full assessment of left ventricular function and other parameters such as the mean velocity of circumferential fiber shortening and mean normalized posterior wall velocity should be included. There is a significant number of hemodialysis patients (7/37) with congestive cardiomyopathic features of the echocardiogram. Their clinical features are no different from the othr patients in this study, except they have a significantly higher prevalence of uremic hyperparathyroidism. A specific uremic cardiomyopathy and uremic hyperparathyroidism may play an important role in the pathogenesis.