Sahar shaker sheta
Cairo University Children\'s Hospital, Egypt
Title: Longitudinal cardiac rotation abnormalities in children and young adults with end-stage renal failure undergoing hemodialysis: A pilot study
Biography
Biography: Sahar shaker sheta
Abstract
Background: Longitudinal cardiac rotation (LR) is a movement of the apex during systole and diastole, with the heart appearing to rotate in a clockwise or counterclockwise direction. In this pilot study, we hypothesized that LR abnormalities are present in children with end-stage kidney disease (ESKD) undergoing hemodialysis (HD). We assessed the effect of preload on LR.
Methods: Twelve patients with ESKD (58% male; aged 17.5 ± 4.4 years) were prospectively studied. Four-chamber views were acquired 1 hour before and after HD. Data were compared with 12 controls. Speckle tracking imaging was used for assessment of LR (°), longitudinal strain (%), and mechanical dyssynchrony (septum-lateral delay).
Results: LR abnormalities were seen in 50% of patients (end-systolic LR < -3.00° or > +3.00°). In 4 patients, LR changed in the opposite direction after HD. LR abnormalities were not seen in controls (LR between -2.00° and +2.00°). Controls showed the highest mean longitudinal strain (patients: - 19.75 ± 1.81% vs controls: - 22.60 ± 3.00%, P < 0.0001). Longitudinal strain decreased significantly after HD (preHD: - 19.75 ± 1.81% vs post HD: - 17.41 ± 1.68%, P < 0.0001). Mechanical dyssynchrony was more pronounced in patients (patients: 140.4 ± 90.0 msec vs controls: 106.4 ± 68.9 msec, P < 0.0001), and increased after HD (preHD: 93.1 ± 84.6 msec vs postHD: 140.4 ± 90.0 msec, P = 0.003).
Conclusions: Patients with ESKD have LR abnormalities, impaired longitudinal strain and more pronounced dyssynchrony. Preload reduction acutely changed the direction of LR in 30% patients.