Cardiac function in dialysis patients evaluated by Doppler echocardiography and its relation to intradialytic hypotension: A new index combining systolic and diastolic function

Aim. patients and methods: Cardiac function of 40 patients on maintenance d ialysis was examined using a new Doppler index combining systolic and diast olic function. Immediately before dialysis, ultrasonic pulsed Doppler was u sed to measure right and left ventricular inflow and outflow waveforms. The sum of the isovolumetric contraction time (ICT) and isovolumetric relaxati on time (IRT) was calculated by subtracting the ejection time from the inte rval between the end of an inflow waveform and the start of the next inflow waveform. The new index was obtained by dividing the sum of the two isovol umetric times by the ejection time. Cardiac function was evaluated in dialy sis patients and healthy controls using new indices of the right and left h eart systems. Results: Indices of the right and left heart systems in dialy sis patients were significantly higher than those in healthy controls. With respect to hypotension during dialysis, patients were divided into two gro ups, a group with decreased blood pressure (group A: 27 patients) and a gro up with normal blood pressure (group B: 13 patients). Only the left heart s ystem index in group A was significantly higher. There were no significant differences in other M-mode Doppler indices between the two groups. Conclus ion: The new index was a more sensitive evaluator of cardiac function and p redictor of hypotension during dialysis compared to standard echocardiograp hic indices.