Abstract
To investigate myocardial damage in hemodialysis patients, coronary flow reserve was measured by the flow wire technique, and early diastolic velocity of the mitral annulus by tissue Doppler imaging (TDI) technique. Seven dialysis patients (mean age 64.8 years) were studied. They had no significant coronary artery stenosis and no diabetes mellitus, but clinical symptoms and ischemic changes on electrocardiography indicated that they might have ischemic heart disease.
Coronary blood flow velocity was recorded by the flow wire technique in the left anterior descending artery (LAD seg. 7) and left circumflex artery (CX seg. 13). Baseline average peak velocity (APV) and hyperemic APV were analyzed. Coronary flow reserve was assessed by the ratio of flow velocity change induced by intracoronary nicorandil (2mg). Early diastolic velocity was recorded by the TDI technique from the lateral mitral annulus.
The coronary flow reserve of LAD and CX was lower (LAD: 2.0±5.5, CX: 2.0±0.3) than those in previous studies of normal subjects. The early diastolic velocity was also lower (9.6±2.0cm/s) than that in previous studies of normal subjects.
In conclusion, the results of this study suggest that hemodialysis patients sustain myocardial damage due to persistent microvascular dysfunction.
