[Doppler Echocardiography Description of Diastolic Function Disorder in Terminal Renal Failure--new Characterization of Uremic Cardiomyopathy]

In order to characterize left ventricular diastolic filling abnormalities in uremic cardiomyopathy in 50 patients on hemodialysis, the ratio VE/VA of peak early (VE) and late (VA) filling velocity was calculated using CW-Doppler echocardiography. Compared with normal subjects of identical age, VE/VA was found to be significantly lower in patients younger than 40 years, but without, however, significant differences in patients aged 40-60 years and older than 60. Thus, the incidence of diminished VE/VA-ratios fell from 64% in patients younger than 40 years to 5% in patients older than 60. Whereas duration of dialysis, extent of renal anemia and interdialytic volumeload showed no influence, diastolic malfunction was correlated to renal hypertension. Therefore, an actualized characterization of uremic cardiomyopathy can be achieved by CW-Doppler echocardiography, describing diastolic malfunction in most patients with terminal renal failure. In elderly patients, however, a distinction from physiologic alteration of diastolic filling is not possible. Clinical significance of diastolic malfunction is characterized by reduced tolerance of interdialytic volume-expansion, as well as intradialytic volume-depletion.