Journal Article

Myocardial fibrosis and diastolic dysfunction in patients on chronic haemodialysis

Maria Angela Losi, Bruno Memoli, Carla Contaldi, Giovanni Barbati, Marco Del Prete, Sandro Betocchi, Massimo Cavallaro, Gerardo Carpinella, Angelica Fundaliotis, Lucia-S Parrella, Valentina Parisi, Bruna Guida and Massimo Chiariello

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 25, issue 6, pages 1950-1954
Published in print June 2010 | ISSN: 0931-0509
Published online January 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfp747
Myocardial fibrosis and diastolic dysfunction in patients on chronic haemodialysis

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Background. Left ventricular (LV) diastolic dysfunction is linked to myocardial collagen content in many cardiac diseases. There are no data regarding such relationship in patients with end-stage renal disease (ESRD) undergoing haemodialysis.

Methods. Twenty-five patients with ESRD undergoing haemodialysis were studied by echocardiography. LV diastolic function was investigated by Doppler echocardiography, by analysing LV filling velocities at rest and during loading manoeuvres, which represent an estimate of LV filling pressure. According to the Doppler pattern, LV filling pressure in a given patient was judged to be normal or slightly increased or to be moderately or severely increased. The presence of myocardial fibrosis was estimated by ultrasound tissue characterization with integrated backscatter, which in diastole correlates with the collagen content of the myocardium.

Results. Integrated backscatter was higher in patients with moderate or severely increased than in patients with normal or slightly increased LV filling pressure (integrated backscatter: 51.0 ± 9.8 vs 41.6 ± 5.6%; P = 0.008). Integrated backscatter was a strong and independent determinant of diastolic dysfunction (odds ratio = 1.212; P = 0.040).

Conclusion. Our data support the hypothesis that, in a selected population of patients with ESRD undergoing haemodialysis, myocardial fibrosis is associated with LV diastolic myocardial properties.

Keywords: diastolic function; ESRD; myocardial fibrosis; tissue characterization

Journal Article.  3717 words.  Illustrated.

Subjects: Nephrology

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