Myocardial tissue Doppler imaging detects right ventricular dysfunction after percutaneous angioplasty of dysfunctional hemodialysis access in uremic patients

Feng Yu Kuo, Wei Chun Huang, Kuan Rau Chiou, Shih Hung Hsiao, Shih Kai Lin, Chi Cheng Lai, Tong Chen Yeh, Tao Yu Lee, Jin Shiou Yang, Tzu Wen Lin, Guang Yuan Mar, Shoa Lin Lin, Chun Peng Liu

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: Right ventricular dysfunction has been observed in uremic patients receiving percutaneous transluminal angioplasty (PTA). This prospective study focuses on the impact of tissue Doppler imaging echocardiographic parameters on assessing right ventricle function in uremic patients post PTA of dysfunctional hemodialysis access. Methods: Sixty uremic patients were divided into two groups by angiographic findings: an occlusive group (26 patients) and a stenotic group (34 patients). All uremic patients underwent routine echocardiography with tissue Doppler imaging both before and immediately following PTA to assess the right ventricular (RV) function and pulmonary artery systolic pressure (PASP). The right ventricular (RV) myocardial performance index (MPI) was obtained during tissue Doppler imaging over the lateral tricuspid annulus. The M index was measured and defined as the peak early diastolic mitral inflow velocity divided by the RV MPI. The RV MPI, RV isovolumic relaxation time (IVRT) and M-index were used to evaluate RV function post-PTA. Results: Immediately following PTA, PASP (31.6 ± 11.3 mmHg versus 42.6 ± 12.0 mmHg, p = 0.001), RVMPI (0.46 ± 0.08 versus 0.62 ± 0.13, p < 0.001) and IVRT (75.1 ± 12.9 versus 98.4 ± 27.7 ms, p < 0.001) increased significantly in the occlusive group. However, PASP and RV function did not change significantly in the stenotic group. In 42.3% patients from the occlusive group, the M-index fell below 112 and RV MPI rose above 0.55 post-PTA; this occurred in only 8.8% of the stenotic group. Conclusions: This prospective study demonstrated that there was a higher incidence of RV dysfunction in uremic patients with elevated PASP with totally occluded hemodialysis access than those with stenotic access post-PTA.

Original languageEnglish
Pages (from-to)136-143
Number of pages8
JournalActa Cardiologica Sinica
Volume30
Issue number2
Publication statusPublished - Jan 1 2014
Externally publishedYes

Keywords

  • Myocardial performance index
  • Percutaneous transluminal angioplasty
  • Pulmonary hypertension
  • Tissue Doppler image
  • Uremic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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