Pre‑ and post‑hemodialysis differences in heart failure diagnosis by current heart failure guidelines in patients with end‑stage renal disease
10.1186/s44348-024-00003-8
- Author:
Bong‑Joon KIM
1
;
Su‑Hyun BAE
;
Soo‑Jin KIM
;
Sung‑Il IM
;
Hyunsu KIM
;
Jung‑Ho HEO
;
Ho Sik SHIN
;
Ye Na KIM
;
Yeonsoon JUNG
;
Hark RIM
Author Information
1. Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Gospel Hospital, Busan, Korea
- Publication Type:RESEARCH
- From:
Journal of Cardiovascular Imaging
2024;32(1):6-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Patients with end-stage renal disease (ESRD) who are on hemodialysis (HD) have reduced vascular com‑ pliance and are likely to develop heart failure (HF). In this study, we estimated the prevalence of HF pre- and post-HD in ESRD using the current guidelines.
Methods:We prospectively investigated HF in ESRD patients on HD using echocardiography pre- and post-HD. We used the structural and functional abnormality criteria of the 2021 European Society of Cardiology guidelines.
Results:A total of 54 patients were enrolled. The mean age was 62.6 years, and 40.1% were male. Forty-five patients (83.3%) had hypertension, 28 (51.9%) had diabetes, and 20 (37.0%) had ischemic heart disease. The mean N-terminalpro brain natriuretic peptide BNP (NT-proBNP) level was 12,388.8 ± 2,592.2 pg/dL. The mean ideal body weight was 59.3 kg, mean hemodialysis time was 237.4 min, and mean real filtration was 2.8 kg. The mean left ventricular ejection fraction (LVEF) was 62.4%, and mean left ventricular end-diastolic diameter was 52.0 mm in pre-HD. Post-HD echocardiography showed significantly lower left atrial volume index (33.3 ± 15.9 vs. 40.6 ± 17.1, p = 0.030), tricuspid regurgitation jet V (2.5 ± 0.4 vs. 2.8 ± 0.4 m/s, p < 0.001), and right ventricular systolic pressure (32.1 ± 10.3 vs. 38.4 ± 11.6, p = 0.005) compared with pre-HD. There were no differences in LVEF, E/E′ ratio, or left ventricular global longitudinal strain. A total of 88.9% of pre-HD patients and 66.7% of post-HD patients had either structural or functional abnor‑ malities in echocardiographic parameters according to recent HF guidelines (p = 0.007).
Conclusions:Our data showed that the majority of patients undergoing hemodialysis satisfy the diagnostic criteria for HF according to current HF guidelines. Pre-HD patients had a 22.2% higher incidence in the prevalence of func‑ tional or structural abnormalities as compared with post-HD patients.
