Left-ventricular diastolic dysfunction as a risk factor for dialytic hypotension
| Autor: | Christelle Loridon, A. Benmaadi, Eric Illouz, Mireille Griuncelli, Guy Rostoker |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Comorbidity Risk Assessment Severity of Illness Index Ventricular Dysfunction Left Age Distribution Predictive Value of Tests Renal Dialysis Internal medicine Severity of illness Natriuretic Peptide Brain Confidence Intervals Medicine Humans Pharmacology (medical) Prospective Studies Risk factor Sex Distribution Prospective cohort study Aged Aged 80 and over Analysis of Variance Heart Failure Diastolic business.industry Incidence Middle Aged medicine.disease Brain natriuretic peptide Echocardiography Doppler Survival Rate Cross-Sectional Studies ROC Curve Heart failure Cardiology Kidney Failure Chronic Female Hemodialysis Hypotension Cardiology and Cardiovascular Medicine business Risk assessment Follow-Up Studies |
| Zdroj: | Cardiology. 114(2) |
| ISSN: | 1421-9751 |
| Popis: | Objectives: Intradialytic hypotension may adversely affect the outcome of chronic hemodialysis and thus reduce the patients’ life expectancy. The aim of this study was to assess the link between left-ventricular diastolic dysfunction and dialytic hypotension. Methods: We performed a prospective cross-sectional study of 72 hemodialysis patients with a low dialysis vintage, 36 of whom had dialysis hypotension, based on echocardiography and brain natriuretic peptide (BNP) assay. Results: There was no difference between normotensive patients and those with dialysis-associated chronic hypotension as regards BNP level, cardiac index, left-ventricular ejection fraction, or myocardial fractional shortening. Both hypotension-prone patients requiring dialysate sodium profiling and chronic refractory hypotensive patients requiring macromolecule infusion had cardiac diastolic dysfunction as shown by a similarly abnormal E/A ratio p, p < 0.05 nonparametric ANOVA). The area under the ROC curve for Vp was 0.69. A Vp cutoff of 39.5 cm/s was optimal for predicting dialysis-associated hypotension. Conclusions: We conclude that diastolic dysfunction is associated with dialytic hypotension and that a low Vp – a preload-independent index – is predictive of dialysis-associated hypotension. |
| Databáze: | OpenAIRE |
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