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Higher ultrafiltration rate is associated with right ventricular mechanical dispersion [Anatol J Cardiol]
Anatol J Cardiol. 2019; 21(4): 206-213 | DOI: 10.14744/AnatolJCardiol.2019.26243  

Higher ultrafiltration rate is associated with right ventricular mechanical dispersion

Serkan Ünlü1, Efstathios Pagourelias2, Burak Sezenöz3, Asife Şahinarslan3, Orhan Mecit Uludağ4, Gökhan Gökalp3, Turgay Arınsoy5, Atiye Çengel3
1Department of Cardiology, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital; Ankara-Turkey
2Aristotle University of Thessaloniki, Hippokrateion University Hospital, Medical School, Third Cardiology Department; Thessaloniki-Greece
3Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey
4Department of Pharmacology, Faculty of Pharmacy, Gazi University; Ankara-Turkey
5Department of Nephrology, Faculty of Medicine, Gazi University; Ankara-Turkey

Objective: Ultrafiltration rate is one of the major determinants of adverse outcomes in patients undergoing hemodialysis (HD) therapy. Previous studies have focused on the impact of HD on right ventricular (RV) peak strain values. However, the influence of HD on the temporal characteristics of deformation has not been reported yet. The aim of the present study was to evaluate the impact of high ultrafiltration rate (HUR) on RV mechanical dyssynchrony.
Methods: Echocardiographic images focused on the RV and left ventricle (LV) were obtained from 60 patients (49.2±17.3 years, 22 female) before and after HD. Patients were divided into two groups according to ultrafiltration rate. Changes in echocardiographic parameters with HD were examined. Two-dimensional speckle-tracking strain analysis was used to assess deformation. Mechanical dispersion was measured as the standard deviation of time to peak longitudinal strain of six segments for RV and 18 segments for LV.
Results: The average ultrafiltrated volume and ultrafiltration rate were 3000.1±1007.9 mL and 11.4±2.9 mL/kg/h, respectively. Global longitudinal strain (GLS) of the RV and LV decreased after HD in both groups. A significant difference was observed in RV mechanical dispersion with HD for patients in the high ultrafiltration group. A mild statistically insignificant increase in LV mechanical dispersion was also observed after HD.
Conclusion: HUR has a substantial impact on LV and RV GLS and RV dyssynchrony. Ultrafiltration rates and volumes should be kept as low as possible to achieve hemodynamic stability and tolerability.

Keywords: dispersion, mechanical, right, speckle, tracking, ventricle


Serkan Ünlü, Efstathios Pagourelias, Burak Sezenöz, Asife Şahinarslan, Orhan Mecit Uludağ, Gökhan Gökalp, Turgay Arınsoy, Atiye Çengel. Higher ultrafiltration rate is associated with right ventricular mechanical dispersion. Anatol J Cardiol. 2019; 21(4): 206-213

Corresponding Author: Serkan Ünlü, Türkiye


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