Impact of Hemodialysis on Left Ventricular-Arterial Coupling in End-Stage Renal Disease Patients

作者全名："Zuo, Ming-Liang; Chen, Qiu-Yi; Pu, Lei; Shi, Lan; Wu, Dan; Li, Hua; Luo, Xian; Yin, Li-Xue; Siu, Chung-Wah; Hong, Da-Qing; Gan, Hua"

作者地址："[Zuo, Ming-Liang; Gan, Hua] Chongqing Med Univ, Affiliated Hosp 1, Dept Nephrol, Chongqing, Peoples R China; [Chen, Qiu-Yi; Shi, Lan; Wu, Dan; Li, Hua; Luo, Xian; Yin, Li-Xue] Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Cardiovasc Ultrasound & Noninvas Cardiol Dept, Chengdu, Peoples R China; [Pu, Lei; Hong, Da-Qing] Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Dept Nephrol, Chengdu, Peoples R China; [Siu, Chung-Wah] Univ Hong Kong, Queen Mary Hosp, Dept Med, Cardiol Div, Hong Kong, Peoples R China"

通信作者："Gan, H (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Nephrol, Chongqing, Peoples R China."

来源：BLOOD PURIFICATION

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001048893600001

JCR分区：Q2

影响因子：2.2

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Echocardiography; End-stage renal disease; Haemodialysis; Left ventricle; Vascular-arterial coupling

摘要："Introduction: As a key determinant of cardiovascular performance, vascular-arterial coupling (VAC) has been reported to be a predictor of clinical outcomes in various clinical scenarios. However, few studies have explored how acute fluid removal during hemodialysis (HD) impacts the interaction between cardiac function and the arterial system. Methods: We recruited 317 HD patients from an established renal dialysis unit for this cross-sectional study and a total of 285 were included in the final analyses. We measured left ventricle end-systolic elastance (Ees), the effective arterial elastance (Ea), and VAC before and after HD using noninvasive echocardiographic measurements. We also compared echocardiographic and hemodynamic parameters in ventriculo-arterial coupling and ventriculo-arterial uncoupling patients. Results: HD significantly altered partial ventricular and vascular function parameters such as blood pressure, left ventricular end-diastolic volume, stroke volume, left ventricular ejection fraction, and systemic vascular resistance index. Ea increased following HD from 3.5 & PLUSMN; 1.4 to 4.2 & PLUSMN; 1.8 mm Hg/mL (p < 0.0001), Ees increased following HD from 7.9 & PLUSMN; 5.5 to 9.2 & PLUSMN; 6.9 mm Hg/mL (p = 0.04), whereas VAC did not markedly alter as a result of HD. Ventriculo-arterial uncoupling was found to be related to abnormal cardiac structure and worse systolic function. Conclusions: VAC obtained from echocardiography is likely to be load-independent and useful as a reliable index for stratifying the risk of cardiovascular diseases in HD patients. Further investigations on larger patient cohorts are needed to further validate our findings."

基金机构："Sichuan Science and Technology Program, China [2020YFQ0060]"

基金资助正文："This work was financially supported by Sichuan Science and Technology Program, China (2020YFQ0060)."