scholarly journals Study of Ventricular Interdependence in Hemodialysis Patients

Author(s):  
Ahmad Bahieldeen Ahmad Abdelrehim ◽  
Ahmed Abdel Haleem Ahmed ◽  
Salwa Salah Elgendi ◽  
Walaa Hosny Muhammad

Abstract Background and objectivesStudy of respiratory variations in mitral valve (MV) Doppler flow in hemodialysis (HD) patients has not been investigated and normal adult referenced echocardiographic value is used as an echocardiographic reference to HD patients who have unique hemodynamic. This work aimed to study the respiratory variation in MV Doppler flow in HD patients to determine if it has a unique pattern in these patients, and to study any relation between this variation and volume-related parameters.MethodsWe conducted a prospective cohort study, carried out on 118 patients who underwent regular HD. A standard echocardiography was performed on the patients before and within 6 hs after dialysis. During quiet breathing, the transmitral spectral Doppler E wave was measured during inspiratory and expiratory phases using plethysmography breath-cycle chest-adhesive electrodes. The mathematic differences and the percent changes (ventricular interdependent; VI) in E wave were calculated pre-and post-dialysis. Post dialysis difference in the percent changes (∆ E wave % changes) was calculated as follows: pre-dialysis percent changes of E wave – post dialysis percent changes of E wave/pre dialysis percent changes E wave x 100. ResultsThe means of the mathematic differences between the MV inspiratory and expiratory E pre-and post-dialysis were 0.07 ± 0.18 m/s and 0.08 ± 0.22 m/s respectively with an insignificant difference between both phases; p = 0.337. Meanwhile, the means of the percent variation in the MV inspiratory and expiratory E pre-and post-dialysis were 56 ± 7 % and 44 ± 1.1 % respectively, with a significant reduction after dialysis; P = 0.000. Spearman correlation showed a significant positive correlation between post- dialysis ∆ E wave % change and post-dialysis % change of weight (r = 0.318; P = 0.000). Moreover, post- dialysis % change of weight and post- dialysis % changes of most other volume-related variable were independent predictors of post- dialysis ∆ E wave % in HD patients. ConclusionThe pre- and post- dialysis respiratory changes in the MV E wave in HD patients were higher than the normal adult referenced values. This marked variation could be explained by the unique overloading condition and could explain the LV diastolic dysfunction and the unexplained pulmonary hypertension in HD patients.

2001 ◽  
Vol 14 (11) ◽  
pp. 1119-1126 ◽  
Author(s):  
Jing Ping Sun ◽  
Ibrahim A. Abdalla ◽  
Xing Sheng Yang ◽  
Navin Rajagopalan ◽  
William J. Stewart ◽  
...  

2004 ◽  
Vol 30 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Andrew Walker ◽  
Eva Olsson ◽  
Bengt Wranne ◽  
Ivar Ringqvist ◽  
Per Ask

1998 ◽  
Vol 47 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Christian Peters-Engl ◽  
Michael Medl ◽  
Michael Mirau ◽  
Christian Wanner ◽  
Selcuk Bilgi ◽  
...  

1993 ◽  
Vol 75 (4) ◽  
pp. 1781-1789 ◽  
Author(s):  
S. T. Kuna ◽  
G. Insalaco ◽  
D. R. Villeponteaux ◽  
C. R. Vanoye ◽  
J. S. Smickley

The electrical activity of the arytenoideus muscle, a vocal cord adductor, was measured in 14 normal adult humans during progressive isocapnic hypoxia and progressive hyperoxic hypercapnia. Electromyograms of the arytenoideus were obtained with intramuscular hooked-wire electrodes implanted by means of a fiber-optic nasopharyngoscope. Correct placement of the electrodes was confirmed by discharge patterns during voluntary maneuvers. In three of the subjects, respiratory-related arytenoideus activity was not present during quiet breathing or chemical stimulation. During quiet breathing in the 11 other subjects, the arytenoideus exhibited phasic activity during expiration and usually tonic activity throughout the respiratory cycle. Phasic and tonic arytenoideus activity decreased under hypoxic and hypercapnic conditions. At higher levels of chemical stimulation in many subjects, short abrupt bursts of activity were frequently present at the transitions between inspiration and expiration. To determine the mechanical effect of the latter electromyographic findings, arytenoideus activity and fiber-optic images of the glottic aperture were simultaneously recorded in nine additional normal adult human subjects during progressive hyperoxic hypercapnia. The short abrupt bursts of arytenoideus activity were usually associated with a decrease in glottic aperture, although no change and an increase in glottic aperture were observed in individual subjects. The results suggest that the arytenoideus muscle may have an important role in the control of ventilation in normal human subjects.


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