Ultrasonic videodensitometric analysis of myocardium in end-stage renal disease treated with haemodialysis

Background. The aim of this study was to investigate videodensitometric par ameters of the myocardium, in dialysis patients, who represent a complex pa thophysiological model of pressure-volume overload, and in essential hypert ensive patients with the same level of left ventricular mass. Methods. We compared a group of male dialysis patients (D) with two groups: hypertensive patients (H) with comparable left ventricular mass and normot ensive healthy subjects as controls (C). The groups (n = 15 each) were age- (53+/-9 years) and gender-matched. Quantitative analysis of echocardiograp hic digitalized imaging was performed to calculate the mean grey level (MGL ) and cyclic variation index (CVI). Results. The haemodialysis patients had a significantly lower CVI compared with hypertensives and controls both for septum (D): -2.5 +/- 17.4% vs (H); 11.8 +/- 17% vs (C); 43.2 +/- 15.4% (P < 0.001) and for posterior wall (D) : -10.1 +/- 261% vs (H); 14.2 +/- 14.7% vs (C); 46.6.2 +/- 17.2% (P < 0.001 ). A significant inverse relationship was found between intact parathyroid hormone (iPTH) and CVI. Conclusion. Abnormalities of two-dimensional echocardiographic grey level d istribution are present in both haemodialysis patients and hypertensive pat ients, but seem unrelated to the degree of echocardiographic hypertrophy. T hese videodensitometric myocardial alterations are significantly higher in dialysis patients than in hypertensive patients with the same extent of lef t ventricular hypertrophy. The iPTH level may play a role in the developmen t of the ultrasonic myocardial alterations, which probably represent an ear ly stage of uraemic cardiomyopathy.