Improved left ventricular contractility with cool temperature hemodialysis

Freda L. Levy, Paul A. Grayburn, Charles J. Foulks, M. Elizabeth Brickner, William L. Henrich

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Abstract

Cool temperature dialysis (CTD) has been shown to sharply decrease the frequency of intradialytic hemodialysis hypotension, but the mechanism of this hemodynamic protection is unknown. Therefore, we performed two-dimensional echocardiographic studies of left ventricular contractility in six stable hemodialysis patients before and after hemodialysis at 37°C (RTD) and 35°C (CTD). Left ventricular function was assessed by plotting the rate-corrected velocity of circumferential fiber shortening (Vcfc) against end-systolic wall stress (σes) at four different levels of afterload. Linear regression was used to calculate Vcfc at a common afterload of 50 g/cm2. Changes in weight and dialysis parameters were similar following RTD and CTD. Mean arterial pressure and heart rate did not change significantly following RTD or CTD. The Vcfc - σes relation was shifted upward in each patient after CTD, indicating increased contractility as compared to RTD or pre-dialysis baseline. Pre-dialysis Vcfc at an afterload of 50 g/cm2 was similar during RTD and CTD (0.94 ± 0.24 circ/sec vs. 0.92 ± 0.22 circ/sec). Postdialysis Vcfc at an afterload of 50 g/cm2 was significantly higher for CTD than for RTD (1.13 ± 0.29 circ/sec vs. 0.98 ± 0.30 circ/sec, P = 0.0004). Thus, cool temperature dialysis increases left ventricular contractility in hemodialysis patients, which may be a potential mechanism whereby hemodynamic tolerance to the dialysis procedure is improved.

Original languageEnglish (US)
Pages (from-to)961-965
Number of pages5
JournalKidney International
Volume41
Issue number4
StatePublished - Apr 1992

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Renal Dialysis
Dialysis
Temperature
Hemodynamics
Left Ventricular Function
Hypotension
Linear Models
Arterial Pressure
Heart Rate
Weights and Measures

ASJC Scopus subject areas

  • Nephrology

Cite this

Levy, F. L., Grayburn, P. A., Foulks, C. J., Brickner, M. E., & Henrich, W. L. (1992). Improved left ventricular contractility with cool temperature hemodialysis. Kidney International, 41(4), 961-965.

Improved left ventricular contractility with cool temperature hemodialysis. / Levy, Freda L.; Grayburn, Paul A.; Foulks, Charles J.; Brickner, M. Elizabeth; Henrich, William L.

In: Kidney International, Vol. 41, No. 4, 04.1992, p. 961-965.

Research output: Contribution to journalArticle

Levy, FL, Grayburn, PA, Foulks, CJ, Brickner, ME & Henrich, WL 1992, 'Improved left ventricular contractility with cool temperature hemodialysis', Kidney International, vol. 41, no. 4, pp. 961-965.
Levy FL, Grayburn PA, Foulks CJ, Brickner ME, Henrich WL. Improved left ventricular contractility with cool temperature hemodialysis. Kidney International. 1992 Apr;41(4):961-965.
Levy, Freda L. ; Grayburn, Paul A. ; Foulks, Charles J. ; Brickner, M. Elizabeth ; Henrich, William L. / Improved left ventricular contractility with cool temperature hemodialysis. In: Kidney International. 1992 ; Vol. 41, No. 4. pp. 961-965.
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