Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Sahar Sheta, Lagies R, Beck B.B, Hoppe B, Sreeram N and Udink ten Cate F.E.A
Cairo University Children's Hospital (CUCH), Egypt
University Hospital of Cologne, Germany
University Hospital of Cologne, Germany
Scientific Tracks Abstracts: J Clin Exp Cardiolog
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 also 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 postHD: - 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.
Email: sssheta@yahoo.com