Doppler Echocardiographic Study on the Changes of Cardiac Performance and Valvular Regurgitation before and after Hemodialysis

In 22 end-stage renal disease patients on regular hemodialysis, echocardiographic study including 2-D Doppler echocardiogrphy was performed to evaluate the effect of hemodialysis on cardiac performance and the degree of valvular regurgitation. After hemodialysis, there were significant improvement of ventricular contractility and reduction of circulating volume in accordance with the reduction of degree of valvular regurgitation in comparison with before hemodialysis. We postulate that the reduction of valvular regurgitation after hemodialysis is caused by relief of hypervolemic state.

Color Doppler Assessment of Mitral Regurgitation

Color Doppler echocardiographic examination was performed to detect and evaluate semiquantitatively the severity of mitral regurgitation in 38 patients who underwent left ventriculography. The sensitivity and specificity of the technique in the detection of mitral regurgitation was 84% and 100% as compared with left ventriculography.Mitral regurgitation in the false negative cases was mostly mild. On the bases of the farthest distance reached by the regurgitation flow signal from the mitral value orifice, the severity of regurgitation was graded on a four point scale and these results were compared with those of angiography. A significant correlation(r=0.87) was found between Doppler imaging and angiography in the evaluation of the severity of mitral regurgitation.Also results was obtained for the evaluation based on the area covered by the regurgitant signals in the left atrial cavity & the regurgitant jet area(RJA) experssed as a percentage of the left atrial are(LLA) obtained in the same plane(RJA/LLA%). In conclusion, Color Doppler echocardiography is a useful noninvasvive thechique that is not only sensitive and specific in the identification of mitral regurgitation but also provides accurate estimation og its severity.