Back
Cardiovascular disease is the main cause of mortality in chronic hemodialysis patients. The diagnosis of cardiac anomalies by transthoracic echocardiography (TTE) is an important part of the individualisation of patients at high cardiovascular risk. The aim of this study was to describe echocardiographic anomalies in chronic hemodialysis patients in Diourbel and to assess the factors associated with their occurrence.
This was a descriptive and analytical cross-sectional study conducted in the hemodialysis and cardiology departments of the Heinrich Lübke Regional Hospital in Diourbel during September 2023. All patients over 18 years of age who had been on hemodialysis for more than 3 months and who consented to participate were included in the study. They all had a cardiac Doppler ultrasound performed after the hemodialysis session by the same cardiologist. Echocardiographic data were collected, along with other socio-demographic data, history, dialysis parameters and biological tests.
Thirty-three patients (20 women, mean age 49.64 ± 12.62 years) were included, with a mean duration on hemodialysis of 37.8 ± 29.3 months. The most common cause of chronic kidney disease was nephropathy of undetermined cause (45.5%). Echocardiographic anomalies were dominated by left ventricular diastolic dysfunction in 90.9% of patients, with a predominance of type I diastolic dysfunction (60%), and left ventricular hypertrophy (LVH) in 66.7% of patients. LVH was concentric in 50% of patients. Pulmonary arterial hypertension (PAH) was observed in 60.6% of patients, with a predominance of severe PAH (50%). Valvular calcifications were noted in 45.5% of patients, predominantly in the aortic valve (60%). Kinetic disorders (12.1%) and left ventricular systolic dysfunction (9.1%) were the least common anomalies. On univariate analysis, blood phosphate (p = 0.04) and calcium phosphate product (p = 0.04) were significantly higher in patients with valvular calcifications. The diameters of the inferior vena cava (p < 0.001), left atrium (p < 0.03), telediastolic (p < 0.03) and telesystolic left ventricle (p < 0.003) were significantly higher in patients with PAH.
Our results demonstrate the need for regular TTE in chronic hemodialysis patients. Anomalies are frequent and can be a source of morbidity and mortality.