THE EVALUATION OF ECHOCARDIOGRAPHIC FEATURES AND CARDIOVASCULAR MORTALITY IN THE HEMODIALYSIS PATIENTS

ABSTRACT Echocardiographic abnormalities are frequently seen in patients starting dialysis therapy and are also associated with the development of cardiac failure and mortality. In the present study, it was aimed to evaluate the left ventricular hypertrophy (LVH) detected by echocardiography and other echocardiographic factors and cardiovascular mortality in hemodialysis patients (HD).

In this descriptive and cross-sectional study, 32 HD patients who died between December 1998 and November 2000were evaluated. Baseline echocardiograms were carried out in all HD patients. Echocardiographic parameters, blood pressure, anemia, levels of albumin and parathormone, age and gender were determined. They were M/F: 20/12, with systolic blood pressure (SBP): 146+41 mmHg and diastolic blood pressure (DBP): 82±19 mmHg. Mean age of cases was a 54±17 yr and mean hematocrit level was 21+3% at the beginning of the chronic HD program. 

In the present study, we determined that cardiovascular mortality (53.1%) is the leading cause of death in HD patients. We found that cases had generally moderate left ventricular hypertrophy (LV wall thickness (LVPWDd): 1.36+0.23 cm), however, diabetic patients had more severe hypertrophy (1.54+0.27 cm, p<0.05) and larger LV end-diastolic diameter (LVDd: 5.41+1.05 cm). We also found highly positive correlations between DBP and LVPWDd, SBP and LVPWDd (r=0.62, p<0.05 and r=0.85, p=0.007, respectively).

As a conclusion, cardiovascular mortality still is the most common cause of death in HD patients. Echocardiographic parameters have been excessively deteriorated in HD patients at the beginning of HD program, and this is rather related hypertension, anemia.