Heart failure with preserved ejection fraction is the most frequent but commonly overlooked phenotype in patients on chronic hemodialysis

• DOI: 10.3389/fcvm.2023.1130618
• Publication Date: 2023-06-01T05:27:07Z
• Authors: Jan Malik; Anna Valerianova; Satu Sinikka Pesi...; Kristyna Michalic...; Zuzana Hladinova; Zdenka Hruskova; Vladimira Bednarova; Katarina Rocinova; Monika Tothova; Marketa Kratochvi...; Lucie Kaiserova; Kristina Buryskov...; Vaclav Lejsek; Martin Sevcik; Vladimir Tesar
• Keywords: end-stage renal disease; high-output heart failure; RC666-701; heart failure; echocardiography; Diseases of the circulatory (Cardiovascular) system; Cardiovascular Medicine; 3. Good health; HFPEF

Heart failure (HF) is a serious complication of end-stage kidney disease (ESKD). However, most data come from retrospective studies that included patients on chronic hemodialysis at the time its initiation. These are frequently overhydrated, which significantly influences echocardiogram findings. The primary aim this study was to analyze prevalence heart and phenotypes. secondary aims were (1) describe potential N-terminal pro-brain natriuretic peptide (NTproBNP) for HF diagnosis in ESKD hemodialysis, (2) frequency abnormal left ventricular geometry, (3) differences between various phenotypes population.We all least 3 months five units who willing participate, had no living transplant donor, life expectancy longer than 6 inclusion. Detailed echocardiography together with hemodynamic calculations, dialysis arteriovenous fistula flow volume calculation, basic lab analysis performed conditions clinical stability. Excess severe overhydration excluded by examination employing bioimpedance.A total 214 aged 66.4 ± 14.6 years included. diagnosed 57% them. Among HF, preserved ejection fraction (HFpEF) was, far, common phenotype occurred 35%, while reduced (HFrEF) only 7%, mildly (HFmrEF) high-output 9%. Patients HFpEF differed following: they older (62 14 vs. 70 14, p = 0.002) higher mass index [96(36) 108(45), 0.015], atrial [33(12) 44(16), < 0.0001], estimated central venous pressure [5(4) 6(8), 0.004] pulmonary artery systolic [31(9) 40(23), 0.006] but slightly lower tricuspid annular plane excursion (TAPSE): 22 5 24 5, 0.04. NTproBNP low sensitivity specificity diagnosing or HFpEF: use cutoff value 8,296 ng/L, 52% 79%. levels related echocardiographic variables, indexed (R 0.56, 10-5) arterial 0.50, 10-5).HFpEF far followed HF. suffering not typical changes also hydration mirrored increased filling pressures both ventricles those without