Left ventricular strain analysis using cardiac magnetic resonance imaging in patients undergoing in-centre nocturnal haemodialysis.
AIM
Intensified haemodialysis is associated with regression of left ventricular (LV) mass. Compared to LV ejection fraction, LV strain allows more direct assessment of LV function. We sought to assess the impact of in-centre nocturnal haemodialysis (INHD) on global LV strain (radial, circumferential, and longitudinal) and torsion by cardiac MRI (CMR).


METHODS
In this prospective, two-centre cohort study, 37 participants on conventional haemodialysis (CHD, 3-4 h/session for three sessions/week) converted to INHD (7-8 h/session for three sessions/week) and 30 participants continued CHD. Participants underwent CMR using a standardized protocol and had biomarker measurements at baseline and 52 weeks.


RESULTS
Among the 55 participants (mean age 55; 40% women) with complete CMR data, those who converted to INHD had a significant improvement in their global circumferential strain (GCS, P = 0.025), while those continuing CHD did not have any significant changes in LV strain. When the two groups were compared, there was significant improvement in torsion. LV strains were significantly correlated with each other, but not with troponin I, C-reactive protein, or brain natriuretic protein (NT-proBNP), except for global longitudinal strain (GLS) with troponin I (P = 0.001) and NT-proBNP (P = 0.038).


CONCLUSION
Conversion to INHD was associated with significant improvement in GCS over one year of study, although comparisons with the CHD group were not significant. There was also a significant decrease in torsion in the INHD group compared with CHD. Improvement in LV regional function would support the notion that INHD has favourable effects on both LV structure and function.
['Ong|Jann P|JP|', 'Wald|Ron|R|', 'Goldstein|Marc B|MB|', 'Leipsic|Jonathon|J|', 'Kiaii|Mercedeh|M|', 'Deva|Djeven P|DP|', 'Kirpalani|Anish|A|', 'Jimenez-Juan|Laura|L|', 'Bello|Olugbenga|O|', 'Azizi|Paymon M|PM|', 'Wald|Rachel M|RM|', 'Wright|Graham A|GA|', 'Harel|Ziv|Z|', 'Connelly|Kim A|KA|', 'Yan|Andrew T|AT|']
D000328:Adult D000368:Aged D001696:Biomechanical Phenomena D001955:British Columbia D005260:Female D006352:Heart Ventricles D006801:Humans D007676:Kidney Failure, Chronic D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D009200:Myocardial Contraction D009864:Ontario D011237:Predictive Value of Tests D011446:Prospective Studies D020127:Recovery of Function D006435:Renal Dialysis D013997:Time Factors D054159:Torsion, Mechanical D016896:Treatment Outcome D018487:Ventricular Dysfunction, Left D016277:Ventricular Function, Left
cardiac magnetic resonance imaging haemodialysis cardiac strain