Two-dimensional speckle-tracking echocardiography and automated myocardial functional imaging in assessing acute ultrafiltration volume effects on myocardial work

Abstract

Objective:

This study aimed to investigate the impact of different ultrafiltration (UF) volumes (UFVs) during haemodialysis (HD) on cardiac function and myocardial work (MW) indices in patients with kidney failure (KF) undergoing maintenance HD (MHD).

Methods:

A total of 58 participants were enrolled. The patients with KF were stratified into two groups based on their UFV. Data were collected between July 2023 and August 2024 at the Second Affiliated Hospital of Baotou Medical College. Cardiac parameters were measured using echocardiography before and after HD.

Results:

Compared with healthy controls, the KF groups exhibited significantly elevated systolic blood pressure, heart rate and early diastolic mitral inflow velocity to early diastolic mitral annulus velocity ratio, along with reduced global longitudinal strain (GLS), global work efficiency (GWE), global constructive work (GCW) and global work index (GWI; all p < 0.05). Post-HD, the ⩽3% group showed improvements in GLS and GWE, whereas GCW, global wasted work and GWI decreased significantly (p < 0.05). In contrast, the >3% group experienced reductions in left atrial and ventricular size, GCW, GWE and GWI following dialysis (p < 0.05), without significant changes in GLS.

Conclusion:

Ultrafiltration volumes during HD significantly affect MW and cardiac function. Ultrafiltration ⩽3% of dry weight appears to mitigate the adverse impact on cardiac parameters, offering potential clinical value for optimising HD protocols.