Myocardial Functions Estimated by Pulsed Doppler Echocardiography in Patients with Chronic Renal Failure

Huh, Hyun June; Choi, Byung Ho; Hyun, Myung Chul; Lee, Sang Bum

Abstract

PURPOSE
The objectives of this study were to estimate myocardial functions in patients with chronic renal failure by pulsed Doppler echocardiography, and investigate correlation between Doppler and disease parameters.
METHODS
We studied 13 patients with chronic renal failure whose creatinine clearance rate less than 25ml/min. Using pulsed Doppler echocardiography with curve following method, we measured peak velocity, mean velocity, velocity-time integral and peak acceleration of aortic and pulmonic flow velocity curves, and peak velocity, mean velocity, area of rapid filling wave in early relaxation phase(E wave) and filling wave by atrial contraction in late relaxation phase(A wave) and A/E ratios of the peak velocity and area. And we compared these parameters with those of the normal controls, and then those with early chronic renal failure(less than 6 months of disease duration) and those with late chronic renal failure(more than 6 months of disease duration).
RESULTS
In patients with early chronic renal failure, peak velocity, flow time and area of E wave of the mitral flow velocity curves were significantly decreased, and those of A wave were markedly increased and resulted in marked increase in A/E ratios of the peak velocity and area compared with those of the normal controls. In patients with late chronic renal failure, mitral A/E ratio of the peak velocity continued to be increased, and peak velocity, velocity-time integral and peak acceleration of the aortic flow velocity curves were significantly decreased but pulmonary velocity- time integral was increased markedly compared with those of the normal controls.
CONCLUSIONS
Significant increase of mitral A/E ratio in patients with early chronic renal failure and appearance of significant change in aortic flow velocity curves in patients with late chronic renal failure suggest that abnormalities of myocardial relaxation seem to be present in early phase of the chronic renal failure and continued into late phase but abnormalities of myocardial contraction to appear on late phase of the chronic renal failure.