ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
The Effect Of Decreasing Preload On Valvular Regurgitation In Patients Undergoing Dialysis
Dr. Hüseyin ARINÇ,a Dr. Hüseyin GÜNDÜZ,a Dr. Ali TAMER,b Dr. Hakan ÖZHAN,c
Dr. Ramazan AKDEMİR, c Dr. Abdurrahman OĞUZHAN, d Dr. Cihangir UYANa
aKardiyoloji AD, bİç Hastalıkları AD, Abant İzzet Baysal Üniversitesi İzzet Baysal Tıp Fakültesi, BOLU
cKardiyoloji AD, Abant İzzet Baysal Üniversitesi Düzce Tıp Fakültesi, DÜZCE
dKardiyoloji AD, Erciyes Üniversitesi Tıp Fakültesi, KAYSERİ
Objective: In chronic renal patients undergoing dialysis, calculations of left ventricular diameter and mass may be inordinately large and valve regurgitation may be develop to a high degree as a result of volume overload. In our study, we investigated the effect of ultrafiltration on left ventricular and atrial diameters, as well as on the collapsibility of the inferior vena cava and severity of valvular regurgitation present before dialysis.
Material and Methods: A total of 30 patients, 16 male and 14 female, with a diagnosis of end-stage renal disease with hypervolemia and scheduled to undergo ultrafiltration in addition to hemodialysis were included in our study. Before and after ultrafiltration, left ventricular diastolic and systolic diameters, interventricular septum and posterior wall diastolic and systolic thicknesses, left atrial and aortic root diameters, and the severity of pericardial effusion, if present, were noted. Mitral, tricuspid, aortic and pulmonary valve functions were measured and, if regurgitation was present, its severity was staged in 4 categories. Inferior vena cava expiratory and inspiratory diameters were measured and a collapsibility index was calculated.
Results: There was a significant decrease in left atrial and ventricular diastolic and systolic diameters after hemodialysis. Although the severity of mitral and tricuspid regurgitation decreased significantly, aortic and pulmonary regurgitation was not affected. A significant decrease in IVC expiratory and inspiratory diameters and an increase in collapsibility were noted.
Conclusion: Dialysis causes significant changes in hemodynamic and echocardiographic parameters due to a decrease in intravascular fluid. In particular, a decrease in the presence and severity of valvular regurgitation occurs as a result of this procedure.Keywords: Heart valve diseases, dialysisTurkiye Klinikleri J Med Sci 2005, 25:364-369
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