Systolic time intervals in haemodialysis patients with normal ejection fraction: An echocardiographic study

Abstract

In this controlled study, systolic time intervals (STI) and diastolic functions were investigated in haemodialysis patients (HDp) with ejection fraction (EF) within normal limits. Echocardiographic findings in 86 HDp (M: F, 47:39, mean age 36+/-13 years) and 51 healthy controls (M: F, 22:29, mean age 37+/-10 years) were compared for STI parameters (prejection period (PEP), left ventricular ejection time (LVET) and STI index (PEP/LVET)) and diastolic dysfunction (isovolumetric relaxation time (IVRT) and E/A ratio and deceleration time). The pre-ejection period (114+/-21 vs 94+/-4 msec, P100 msec and latent systolic dysfunction (STI index>0.4) were randomly distributed, with nearly half (48%) of the patients with prolonged IVRT having an STI index within the normal limits and the other half of the patients with deteriorated STI index having a normal IVRT. The combined systolic and diastolic dysfunction was observed in 30% of the patients. It was concluded that STI indexes deteriorate before an overt systolic dysfunction (normal EF), and that systolic and/or diastolic dysfunction of the myocardium may appear singly or simultaneously because of a common pathogenetic mechanism of myocardial fibrosis.