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Abstract：
BACKGROUND: Patients with end-stage renal disease (ESRD) who are on hemodialysis (HD) have reduced vascular compliance and are likely to develop heart failure (HF). In this study, we estimated the prevalence of HF pre- and post-HD in ESRD using the current guidelines.
METHODS: We prospectively investigated HF in ESRD patients on HD using echocardiography pre- and post-HD. We used the structural and functional abnormality criteria of the 2021 European Society of Cardiology guidelines.
RESULTS: A total of 54 patients were enrolled. The mean age was 62.6 years, and 40.1% were male. Forty-five patients (83.3%) had hypertension, 28 (51.9%) had diabetes, and 20 (37.0%) had ischemic heart disease. The mean N-terminal-pro brain natriuretic peptide BNP (NT-proBNP) level was 12,388.8 ± 2,592.2 pg/dL. The mean ideal body weight was 59.3 kg, mean hemodialysis time was 237.4 min, and mean real filtration was 2.8 kg. The mean left ventricular ejection fraction (LVEF) was 62.4%, and mean left ventricular end-diastolic diameter was 52.0 mm in pre-HD. Post-HD echocardiography showed significantly lower left atrial volume index (33.3 ± 15.9 vs. 40.6 ± 17.1, p = 0.030), tricuspid regurgitation jet V (2.5 ± 0.4 vs. 2.8 ± 0.4 m/s, p < 0.001), and right ventricular systolic pressure (32.1 ± 10.3 vs. 38.4 ± 11.6, p = 0.005) compared with pre-HD. There were no differences in LVEF, E/E\' ratio, or left ventricular global longitudinal strain. A total of 88.9% of pre-HD patients and 66.7% of post-HD patients had either structural or functional abnormalities in echocardiographic parameters according to recent HF guidelines (p = 0.007).
CONCLUSIONS: Our data showed that the majority of patients undergoing hemodialysis satisfy the diagnostic criteria for HF according to current HF guidelines. Pre-HD patients had a 22.2% higher incidence in the prevalence of functional or structural abnormalities as compared with post-HD patients.
METHODS: We prospectively investigated HF in ESRD patients on HD using echocardiography pre- and post-HD. We used the structural and functional abnormality criteria of the 2021 European Society of Cardiology guidelines.
RESULTS: A total of 54 patients were enrolled. The mean age was 62.6 years, and 40.1% were male. Forty-five patients (83.3%) had hypertension, 28 (51.9%) had diabetes, and 20 (37.0%) had ischemic heart disease. The mean N-terminal-pro brain natriuretic peptide BNP (NT-proBNP) level was 12,388.8 ± 2,592.2 pg/dL. The mean ideal body weight was 59.3 kg, mean hemodialysis time was 237.4 min, and mean real filtration was 2.8 kg. The mean left ventricular ejection fraction (LVEF) was 62.4%, and mean left ventricular end-diastolic diameter was 52.0 mm in pre-HD. Post-HD echocardiography showed significantly lower left atrial volume index (33.3 ± 15.9 vs. 40.6 ± 17.1, p = 0.030), tricuspid regurgitation jet V (2.5 ± 0.4 vs. 2.8 ± 0.4 m/s, p < 0.001), and right ventricular systolic pressure (32.1 ± 10.3 vs. 38.4 ± 11.6, p = 0.005) compared with pre-HD. There were no differences in LVEF, E/E\' ratio, or left ventricular global longitudinal strain. A total of 88.9% of pre-HD patients and 66.7% of post-HD patients had either structural or functional abnormalities in echocardiographic parameters according to recent HF guidelines (p = 0.007).
CONCLUSIONS: Our data showed that the majority of patients undergoing hemodialysis satisfy the diagnostic criteria for HF according to current HF guidelines. Pre-HD patients had a 22.2% higher incidence in the prevalence of functional or structural abnormalities as compared with post-HD patients.
摘要：
背景：进行血液透析（HD）的终末期肾病（ESRD）患者的血管顺应性降低，并可能发展为心力衰竭（HF）。在这项研究中,我们使用目前的指南估计了ESRD中HD前后HF的患病率.
方法：我们使用HD前后的超声心动图前瞻性研究了ESRD患者的HF。我们使用2021年欧洲心脏病学会指南的结构和功能异常标准。
结果：共纳入54例患者。平均年龄为62.6岁,40.1%为男性。45例(83.3%)有高血压,28人（51.9%）患有糖尿病，20例(37.0%)患有缺血性心脏病。平均N末端脑钠肽前体（NT-proBNP）水平为12,388.8±2,592.2pg/dL。平均理想体重为59.3公斤，平均血液透析时间为237.4分钟，平均实际过滤量为2.8kg。平均左心室射血分数(LVEF)为62.4%,HD前的平均左心室舒张末期直径为52.0mm。HD后超声心动图显示左心房容积指数明显降低（33.3±15.9vs.40.6±17.1,p=0.030),三尖瓣反流射流V(2.5±0.4vs.2.8±0.4m/s，p<0.001)，和右心室收缩压（32.1±10.3vs.与HD前相比，38.4±11.6，p=0.005）。LVEF没有差异,E/E比率，或左心室整体纵向应变。根据最近的HF指南，共有88.9％的HD前患者和66.7％的HD后患者在超声心动图参数方面存在结构或功能异常（p=0.007）。
结论：我们的数据显示，大多数接受血液透析的患者符合目前HF指南的HF诊断标准。与HD后患者相比，HD前患者的功能或结构异常患病率高22.2％。
方法：我们使用HD前后的超声心动图前瞻性研究了ESRD患者的HF。我们使用2021年欧洲心脏病学会指南的结构和功能异常标准。
结果：共纳入54例患者。平均年龄为62.6岁,40.1%为男性。45例(83.3%)有高血压,28人（51.9%）患有糖尿病，20例(37.0%)患有缺血性心脏病。平均N末端脑钠肽前体（NT-proBNP）水平为12,388.8±2,592.2pg/dL。平均理想体重为59.3公斤，平均血液透析时间为237.4分钟，平均实际过滤量为2.8kg。平均左心室射血分数(LVEF)为62.4%,HD前的平均左心室舒张末期直径为52.0mm。HD后超声心动图显示左心房容积指数明显降低（33.3±15.9vs.40.6±17.1,p=0.030),三尖瓣反流射流V(2.5±0.4vs.2.8±0.4m/s，p<0.001)，和右心室收缩压（32.1±10.3vs.与HD前相比，38.4±11.6，p=0.005）。LVEF没有差异,E/E比率，或左心室整体纵向应变。根据最近的HF指南，共有88.9％的HD前患者和66.7％的HD后患者在超声心动图参数方面存在结构或功能异常（p=0.007）。
结论：我们的数据显示，大多数接受血液透析的患者符合目前HF指南的HF诊断标准。与HD后患者相比，HD前患者的功能或结构异常患病率高22.2％。
