Abstract
ABSTRACT
overview
While most studies focus on evaluating left ventricular function, right ventricular function seems to receive little attention, especially in patients with end-stage renal disease on dialysis.
Objective
Examine several indicators of right ventricular function assessment on echocardiography and evaluate the correlation between right ventricular function and clinical characteristics in patients with hemodialysis.
Subjects and methods
Cross-sectional descriptive study, from March 2023 to November 2023 at 115 Nghe An General Hospital. At the end of follow-up, 46 end-stage patients on hemodialysis participated in the study.
Results
The average RVD1 was 36,2 ± 4,8; mean RVD2 was 25,5 ± 3,8; mean RVD3 was 52,8 ± 4,2; mean RAVI was 27,8 ± 6; 26,1% of patients had RAVI above the upper normal limit according to gender; mean PAPs were 37,7 ± 8,1 mmHg. 54,3% of patients had pulmonary hypertension (PAPs >35mmHg); the average RIMP TDI index was 0,54 ± 0,33; the average tricuspid S' was 15,7 ± 4,6 (cm/s); the average E/e' was 5,2 ± 1,2; RIMP TDI was the index that detects the most abnormal patients among the indexes assessing right ventricular systolic function with 23,9%. There were 17,4% of patients with abnormalities in all three indices TAPSE, RIMP TDI, and tricupid S'. The RIMP TDI index was significantly higher in the brachial AVF group compared with the forearm AVF group (0,42 ± 0,25 vs. 0,64 ± 0,35; p=0,016); Tricuspid S' index was significantly lower in the brachial AVF group compared with the forearm AVF group (17,7 ± 3,5 vs. 14,2 ± 4,8; p=0,008); Tricupid E/e' index was significantly higher in the brachial AVF group compared with the forearm AVF group (4,7 ± 0,7 vs. 5,6 ± 1,4; p = 0,012). Dialysis time has a moderate positive correlation with RIMP TDI (r2 = 0,420; p = 0,004); dialysis time has a moderate negative correlation with tricuspid S' (r2= -0,469; p=0,001); dialysis time has a weak positive correlation with tricuspid E/e' (r2= 0,269; p = 0,049).
Conclusion
The average RVD1 and RAVI in hemodialysis patients were higher compared to the average threshold in normal people. RIMP TDI was the index that most detects patients with abnormal right ventricular function when compared to TAPSE and tricuspid S'. Many hemodialysis patients had abnormalities in all three indexes: TAPSE, RIMP TDI and tricuspid S'. There was a correlation between right ventricular function indices and dialysis time and location of AVF.
