| Autor: |
G, Caires, A, Drumond, G, Silva, J J, Araújo, A, Cardoso, A, Teixeira, J A, Araújo, I, Mendonça, M, Diniz |
| Rok vydání: |
1998 |
| Předmět: |
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| Zdroj: |
Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology. 17(7-8) |
| ISSN: |
0870-2551 |
| Popis: |
The aim of this study was to analyse different ultrasound parameters for the assessment of isolated left ventricular diastolic dysfunction (LVDD) in patients with chronic renal failure (CRF) on periodic hemodialysis (HD), comparing pulsed wave Doppler with pulsed tissue Doppler.Forty-seven patients with CRF on HD (61% were male; mean age was 51.0 +/- 16.5 years, mean HD time--3.7 +/- 3.8 years, 38% had hypertension, 17% had diabetes) were studied by echocardiography (bidimensional, M-Mode, flow pulsed Doppler and tissue Doppler imaging). All patients had symptoms of left heart failure-class II NYHA, were in sinus rhythm and had no symptoms of ischemic heart disease. The presence of abnormal LV regional contractility was the exclusion criteria. According to their mitral inflow profile Doppler characteristics, patients were included in two groups: Group A (E/A1; n = 21) and B (E/A1; n = 26). We compared: LV dimensions and function, left atrial (LA) dimension. Gaasch index, LV mass index. E and A wave velocities (in flow pulsatile Doppler and tissue Doppler). E/N ratio in tissue Doppler, isovolumetric relaxation time (IVRT) and deceleration time (DT).There were no significant differences in the prevalence of ageor = 65 years male sex, hypertension or diabetes between group A and B patients, and almost all patients were on hemodialytic treatment for more than one year (81% vs 85%: NS). LV hypertrophy was present in almost all group A and B patients (A--95% vs B--85.5%; NS). Group A, compared with group B, had a difference in the Gaasch index (2.45 +/- 0.3 vs 2.08 +/- 0.4; p0.05), E wave velocity in flow pulsatile Doppler and tissue Doppler (cm/sec) (110 +/- 27 vs 62 +/- 20; p0.001 and 41 +/- 15 vs 28.5 +/- 16; p0.05), E/A ratio in tissue Doppler (1.3 +/- 0.4 vs 0.8 +/- 0.3; p0.001). IVRT (msec) (80.7 +/- 15.2 vs 113.5 +/- 28.3; p0.001) and DT (msec) (189.7 +/- 24 vs 278.2 +/- 17.9; p0.001). According to the E'/A' ratio in tissue Doppler, group A patients were divided in another two groups: E'/A'1 (13/21--62%) and1 (8/21--38%) and a significantly longer IVRT (75.8 +/- 9.3 vs 100.9 +/- 3.2; p0.001) and DT (178 +/- 15 vs 240 +/- 20; p0.001) and a greater LA dimension (37.6 +/- 6.9 vs 44.6 +/- 6.9; p0.05) were found.Pulsed wave Doppler is the most useful non invasive method for assessment of global diastolic dysfunction. In our study, 17% of the patients had E/A1 only in the tissue Doppler study. These patients probably had a pseudonormal mitral pattern. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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