Dynamic echocardiographic assessments reveal Septal E/e’ ratio as independent predictor of intradialytic hypotension in maintenance for hemodialysis patients with preserved ejection fraction

Chun Yu Chen, Ning I. Yang, Chin Chan Lee, Ming Jui Hung, Wen Jin Cherng, Heng Jung Hsu, Chiao Yin Sun, I. Wen Wu

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Intradialytic hypotension (IDH) is a frequent and grave complication of hemodialysis (HD). However, the dynamic hemodynamic changes and cardiac performances during each dialytic session have been rarely explored in patients having IDH. Methods: Seventy-six HD patients (IDH = 40, controls = 36) were enrolled. Echocardiography examinations were performed in all patients at the pre-HD, during-HD and post-HD phases of a single HD session. A two-way analysis of variance was applied to compare differences of echocardiographic parameters between IDH and controls over time. The risk association was estimated by using a logistic regression analysis. Results: The IDH patients had a higher ejection fraction during HD followed by a greater reduction at the post-HD phase than the controls. Significant decreases in septal ratios of transmitral flow velocity to annular velocity (E/e’) over times were detected between IDH patients and controls after adjusting for gender, age and ultrafiltration (p = 0.016). A lower septal E/e’ ratio was independently associated with IDH (OR = 0.040; 95% CI = 0.003–0.606; p = 0.02). In contrast, significant systolic and diastolic dysfunctions over time were found in diabetic IDH compared to non-diabetic counterparts. Conclusion: The septal E/e’ ratio was a significant predictor for IDH.

Original languageEnglish
Article number2266
JournalDiagnostics
Volume11
Issue number12
DOIs
Publication statusPublished - Dec 2021
Externally publishedYes

Keywords

  • Biomarker
  • Intradialytic hypotension
  • Kidney
  • Left ventricular diastolic dysfunction
  • Two-dimensional echocardiography

ASJC Scopus subject areas

  • Clinical Biochemistry

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