학술대회 안내 사전등록 안내 초록등록 안내 초록등록/관리 숙박및교통 안내


мȸ ǥ ʷ

ǥ : ȣ - 490859   260 
Decreased Slope of Left Ventricular Dilatation Assessed by 3D Echocardiography after Preload Reduction is Related to Diastolic Tissue Velocity Change
가천의대 길병원 심장내과¹ 신장내과²
신미승¹, 오규진¹ 심은옥¹ 이준승² 정욱진¹ 최인석¹ 신익균¹
Background: Left ventricular (LV) volume and diastolic function have been known to be decreased after hemodialysis. However LV stiffness change according to preload change was not well studied in hemodialysis. The purpose of this study is to evaluate LV volume change curve during cardiac cycle before and after hemodialysis and to correlate this data with tissue velocity data. Methods: Twenty-six patients (age 51 ± 13 years, 13 males) with end-stage renal disease were studied by Tissue Doppler Imaging (TDI) and real time 3D echocardiography (RT3DE) before and after hemodialysis. TDI sample volume was placed at the basal and mid-segment of septum, lateral, anterior and posterior wall of LV in apical view. Tissue velocity, strain and strain rate were measured. RT3DE was performed in apical 4-chamber view and time-volume curve of LV was obtained by modified automatic contour detection method. The slope of LV diastolic volume change was calculated from LV time-volume curve. Results: Mean body weight change was 2.5 ± 0.7kg. LV end-diastolic volume was decreased from 89.8 ± 46.1 ml to 80.3 ± 47.4 ml (p < 0.05). Peak systolic tissue velocity of each segment of LV was not significantly changed but the early diastolic tissue velocity was significantly decreased after hemodialysis (from 5.7 ± 2.6 to 4.8 ± 2.3 cm/sec in basal segment of the LV posterior wall, from 5.0 ± 1.8 to 3.9 ± 1.7 cm/sec in average value, both p < 0.05). LV strain, strain rate and ejection fraction were not significantly different after hemodialysis. The slope of LV diastolic volume change was decreased from 0.14 ± 0.05 to 0.08 ± 0.03 ml/msec (p < 0.05). Average early diastolic tissue velocity was correlated with the slope of LV diastolic volume change in pre- and post-hemodialysis (r = 0.36 and 0.34, p < 0.05). Early diastolic transmitral flow velocity, early to late diastolic flow velocity ratio and peak velocity of pulmonary venous diastolic flow were significantly decreased (p < 0.05) after hemodialysis. Conclusion: The slope of LV diastolic volume change is decreased after hemodialysis and related to regional diastolic tissue velocity.


[ư]