The Association between right ventricular dysfunction and pulmonary hypertension in hemodialysis patients with end stage renal failure in Karbala city.

Abstract

Background and objective: Pulmonary hypertension together with right ventricular dysfunction are considered as risk factors that increase mortality and morbidity in patients with renal impairment, fluid over load and high systolic blood pressure. The current study tries to investigate any association between hemodialysis, right ventricular dysfunction and pulmonary hypertension.Patients and method.This is a cross-sectional study performed to predict the association of end-stage renal disease and dialysis with right ventricular dysfunction and pulmonary hypertension. Thirty patients (age range 35-68 years) in hemodialysis unit in Imam- Al-Hussein Medical City in Karbala, Iraq were assessed for pulmonary hypertension and right ventricular dysfunction. Whereas, twenty control persons (age range 34-65 years) who had no renal failure and no dialysis were assessed for the same purpose. Heart failure, obstructive air way disease and cardiac disease were excluded from the study. Echocardiography study was performed after taking informed consent from all participants. Blood pressure and cardiac (and pulmonary) indices were measured and finding were statistically analyzed to detect any association. All the above findings were compared in the two study groups. Result: The average systolic diastolic blood pressure was significantly higher in hemodialysis than in control group. Regarding echocardiography, the following indices were found in the dialysis group: LVH, increase long RT ventricular dimension, increase RT ventricle fraction area change, increase tricuspid plane systolic excursion, decrease in systolic velocity at tricuspid valve, increased RT ventricular wall thickness and increase in systolic pulmonary artery pressure. In addition, the dialysis group showed increase mid zone RT Ventricular dimension , though the difference of the latter was non-significant. Conclusion: Data of the current study revealed high incidence of pulmonary hypertension and right ventricular dysfunction among hemodialysis patients with chronic renal failure.