Doppler Tissue Imaging-Derived Left Ventricular Myocardial Performance Index and Cardiac Time Intervals in Chronic Hemodialysis Patient

Background: Changes in the diastolic and systolic function of the LV are linked to end-stage renal disease (ESRD). For a wide range of clinical problems, tissue Doppler imaging (TDI) is regarded as an additional echocardiographic diagnostic tool.
Objective: This study aimed to assess left ventricular (LV) time intervals and the myocardial performance index in chronic HD patients using Doppler tissue imaging before and after HD sessions. 
Methods: Fifty patients participated in this study with regular HD for at least six months, with good functioning arteriovenous (AV) fistula and aged >18 years old. Full history taking, clinical examination and blood tests were done. Conventional echocardiographic and TDI were recorded for all cases with assessing LV myocardial performance index (MPI) pre- and post-haemodialysis session
Results: Body weight, systolic and diastolic blood pressure, left ventricular end-diastolic and end-systolic diameters, ejection percent, E wave velocity, and E/A ratio were all much greater in pre-hemodialysis measurements than in post-hemodialysis measurements. On the other hand, parameters such as isovolumetric relaxation time, E wave deceleration time, and myocardial performance indices assessed by Doppler were notably increased after dialysis. No significant differences were observed in heart rate or in tissue Doppler-derived indices, including isovolumetric relaxation time (IVRT), isovolumetric contraction time (IVCT), and their calculated values, between the pre- and post-dialysis periods.
Conclusions: Essential hemodynamic and structural heart parameters were greatly decreased by HD. Standard flow LV MPI index measured from Doppler was impacted by hemodialysis. The LV MPI index produced from TDI was not, even though these major changes happened, the TDI-derived MPI was not affected.