Hemodiyalizin Sağ ve Sol Ventrikül Fonksiyonlarına Akut Etkisinin Doku Doppler Görüntüleme ile Değerlendirilmesi

Amaç: Doku Doppler görüntüleme, sağ ve sol ventrikülün fonksiyonlarının non-invazif değerlendirilmesine olanak verir. Çalışmamızın amacı, hemodiyalizin sağ ve sol ventrikül fonksiyonlarına akut etkisini non-invazif olarak doku Doppler görüntüleme aracılığıyla değerlendirmektir. Yöntem: Çalışmamızda kronik hemodiyaliz proğramına devam eden 30 hasta (ortalama yaş: 45 ± 15 yıl) incelendi. Hemodiyaliz öncesi ve sonrasında farklı kardiyak bölgelerden miyokardiyal (Sm, Em, Am) ve annüler (Ea, Aa) velositeler doku Doppler aracılığıyla ölçüldü. Bulgular: Hemodiyaliz sonrası, Ea anlamlı olarak 10.8 ± 3.4 cm/s"den 9.6 ± 2.4 cm/s" ye düştü (p = 0.029) Ölçüm yapılan tüm kardiyak segmentlerde hemodiyaliz sonrası ölçülen Em değeri anlamlı olarak daha düşük bulundu. Ölçüm yapılan her kardiyak segmentte ayrı ayrı olmak üzere Em/Am oranı hemodiyaliz sonrasında anlamlı derecede düştü. Sağ ventrikül değerlendirmesinde ölçüm yapılan tüm segmentlerde Sm, Em ve Am anlamlı olarak hemodiyaliz sonrası düştü. Ön duvar Em değeri, ultrafiltrasyon volümüyle pozitif ilişkili saptanırken; (r = 0.25, p = 0.006) sağ ventrikül bazal segmentinde Sm değerindeki düşüş diyastolik kan basıncı düşüşüyle korele bulundu. (r=0.23, p

Anahtar Kelimeler:

doku Doppler görüntüleme, hemodiyaliz, sol ventrikül fonksiyonları, sağ ventrikül fonksiyonları

Acute Effects of Hemodialysis on Left and Right Ventricular Function: A Doppler Tissue Imaging Study

Purpose: Doppler tissue imaging (DTI) allows noninvasive assessment of both left ventricular (LV) and right ventricular (RV) function. The aim of this study was to evaluate the effect of hemodialysis (HD) on LV and RV function using DTI. Method: Our study group included 30 patients on chronic HD program (mean age 45 15 years). Myocardial (Sm, Em, Am) and annular velocities (Ea, Aa) were measured in several cardiac territories before and after HD. Results: After HD, Ea significantly reduced from 10.8 3.4 cm/s to 9.6 2.4 cm/s (p = 0.029). Patients exhibited a lower Em following HD in all measured territories. Em/Am ratio was also reduced for each LV wall investigated after HD in all measured territories. At the RV segments, Sm, Em, and Am decreased significantly in all measured territories. Em of the anterior wall was positively related to ultrafiltration volume (r = 0.25, p = 0.006), whereas the decrease of Sm of RV basal segment correlated with a decrease of diastolic blood pressure (r = 0.23, p < 0.01). Conclusion: Our data indicate that a single HD session is associated with acute changes of systolic and diastolic parameters of LV and RV.

Keywords:

tissue Doppler imaging; hemodialysis; left ventricular function; right ventricular function.,

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