酒井 雅司

Masashi SAKAI

東邦大学第三内科

The 3rd Dept. of Int. Med., School of Med., Toho Univ.

キーワード : hemodialysis, echocardiography, left ventricular function

By using echocardiography, hemodynamic changes were studied on well controlled hemodialysis patients before and at 1, 24, 48 and 72 hours after hemodialysis. They were divided into two groups by removed volume of body fluids. Group I consisted of 9 patients who decreased less than 1% of body weight, group II consisted of 16 patients who decreased 3 to 5% of body weight by hemodialysis.
Heart rate, mean blood pressure, left ventricular end-systolic dimension and diastolic descent rate of mitral valve changed significantly at an hour after hemodialysis in group II. However, these values returned to the previous values at 24 hours after hemodialysis, and continued for 72 hours. Left ventricular end-diastolic dimension, stroke index, cardiac index, left atrial dimension and aortic excursion decreased significantly at an hour after hemodialysis in both groups and these returned to the previous values after 24 hours of hemodialysis. Ejection fraction in both groups and mean Vcf in group I showed no significant changes, but mean Vcf in group II increased significantly after an hour of hemodialysis.
The present study indicates that preload in both groups, afterload in group II decreases temporarily after hemodialysis, and hemodynamics is influenced by not only removed volume but other factors, and reduced cardiac contractility before hemodialysis may be improved by removed body fluids.