Hemodialysis does not affect ventricular-arterial coupling beyond the reduction of blood pressure and preload

摘要

Combined ventricular-arterial coupling defines the efficiency of the myocardium as a pump. The mechanical energy transferred from the ventricular elastance to the arterial elastance is optimal when the two elastances are equal [1 ]. In hypertension and aging, as well as in patients with renal dysfunction, increased arterial stiffness coupled by a matched increase in ventricular stiffness has been reported [2,3]. These findings have important hemodynamic consequences, since a stiff heart-arterial system generates more systolic pressure change for a given stroke volume (SV). In particular, patients with end stage renal disease (ESRD) on hemodialysis (HD) are characterized by central volume fluctuations related to volume expansion in the interdialytic period and fluid loss during hemodialysis [4]. The present study was designed to evaluate the influence of hemodialysis on ventricular-arterial coupling in end stage renal disease (ESRD) patients.