1998 Volume 31 Issue 10 Pages 1335-1342
Analysis of the long-axis motion of the left ventricle is considered useful for detecting cardiac dysfunction at an early stage. This study evaluated the usefulness of this technique in patients receiving maintenance hemodialysis. We examined 32 patients on long-term hemodialysis (Group HD) and 20 healthy controls. We divided Group HD into two subgroups based on total left ventricular wall thickness (TLVT): Group LVH (10 patients with TLVT≥2.4cm), and Group NH (22 patients with TLVT<2.4cm). Echocardiographic examination was performed before a hemodialysis session. In addition to the conventional echocardiogram, the LV long-axis M-mode image was recorded on the left side of the mitral ring from an apical four-chamber view. The following indices were determined: TLVT and fractional shortening (FS) from M-mode echocardiography; early and late diastolic peak velocities (E, A) and E/A from pulsed Doppler transmitral flow signals; and total excursion of the long-axis motion of the mitral ring (TLAM), early diastolic component of TLAM (ELAM), component of TLAM during atrial contraction (ALAM) and maximal velocity of relaxation (max LAM relax) based on longaxis M-mode echocardiography. In Group HD compared with normal controls, TLVT, A and ELAM were increased, and E/A, ALAM and max LAM relax were decreased. FS, E, A, E/A, TLAM, ALAM and max LAM relax did not show any significant differences between Group LVH and Group NH, while ELAM was lower in Group LVH than in Group NH. These results indicate that patients on maintenance hemodialysis show diastolic dysfunction, and that left ventricular hypertrophy have severe diastolic dysfunction from the perspective of the long-axis motion of the left ventricle. We conclude that long-axis M-mode echocardiography is useful for assessing cardiac function in patients receiving maintenance hemodialysis.
