LEFT-VENTRICULAR DIASTOLIC FUNCTION IN PATIENTS ON MAINTENANCE HEMODIALYSIS - COMPARISON WITH HYPERTENSIVE HEART-DISEASE AND HYPERTROPHIC CARDIOMYOPATHY

To elucidate the differences in the left ventricular diastolic functio n between patients on maintenance hemodialysis with left ventricular h ypertrophy and the those with left ventricular hypertrophy from other causes, 20 patients on maintenance hemodialysis (HD group; mean age 44 +/- 12 years), 12 patients with hypertensive heart disease (HHD group ; mean age 43 +/- 10 years), and 10 patients with hypertrophic cardiom yopathy (HCM group; mean age 43 +/- 11 years) were examined non-invasi vely using diastolic time intervals and digitized echocardiograms. Ten age-matched healthy men (N group; mean age 43 +/- 12 years) were also examined. Compared with the HCM group, the HD and HHD groups had a de creased total left ventricular wall thickness and left atrial dimensio n, an increased ratio between the left ventricular enddiastolic dimens ion and total left ventricular wall thickness. The isovolumic relaxati on and rapid relaxation periods were prolonged in the order of HCM, HH D, HD and N, but the active suction period was prolonged only in the H CM group. The peak rate of change in the left ventricular dimension du ring the rapid filling period was decreased in the HCM group, compared with the HD and the HHD groups. These results indicate that hemodialy sis patients with left ventricular hypertrophy have some impairment in left ventricular diastolic function, but the degree of the disturbanc e is similar to that observed in those with hypertensive heart disease , but milder than that observed in those with hypertrophic cardiomyopa thy.