Dynamic Novel Cardiac Imaging Parameters in Home Nocturnal Hemodialysis
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Date
2012-03-12
Authors
Zhu, Mike
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Abstract
BACKGROUND: Most patients on dialysis have left ventricular hypertrophy (L VH) as seen on
cardiac imaging. Nocturnal home hemodialysis (NHD) may produce regression of L VH and
may also improve other cardiac and non-cardiac parameters.
OBJECTNE: To evaluate whether NHD improves cardiac parameters as assessed by cardiac
imaging, and to explore whether this improvement correlates with any of the other measures of
health we used.
METHODS: TIns observational cohort study involved information from cardiac imaging, medical
history, clinical examination, lab data, and quality of life data from five patients, collected when
they began NHD and again at one-year follow-up.
RESULTS: Left ventricular mass index (LVMI) decreased for all patients at follow-up from
35±2g/m2 at baseline to 33±2g/m2 at 12 months (p<O.0009). Left atrial volume index (LA VI)
also decreased for all patients at follow-up, from 140±2 to 136±3mL/m2 (p<O.009). Diastolic
dysfunction improved in almost all patients (p=O.06) at follow-up. Pre-dialysis systolic blood
pressure decreased from 118±lJto 107±12l11!11Hg (p<O.02) at follow-up.
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CONCLUSION: NHD improves LVMI, LA VI, and blood pressure within one year of the switch
from conventional in-center hemodialysis. Converting to NHD is also associated with a strong
trend towards improvement of diastolic dysfunction.
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medicine