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Nephrol Dial Transplant (1999) 14: 2184-2191
© 1999 European Renal Association-European Dialysis and Transplant Association

Preliminary Reports

Ultrasonic videodensitometric analysis of myocardium in end-stage renal disease treated with haemodialysis

Vitantonio Di Bello, Vincenzo Panichi, Roberto Pedrinelli1, Davide Giorgi, Massimiliano Bianchi, Alessio Bertini, Daniele Taccola, Stefano De Pietro, Enrica Talini, Marco Paterni2 and Costantino Giusti

1 Dipartimento di Medicina Interna e di Cardiologia, University of Pisa and 2 Istituto di Fisiologia Clinica, CNR, Pisa, Italy

Correspondence and offprint requests to: Vitantonio Di Bello, MD, Dipartimento di Medicina Interna, Università di Pisa, via Roma, 67, I-56100 Pisa, Italy.

Background. The aim of this study was to investigate videodensitometric parameters of the myocardium, in dialysis patients, who represent a complex pathophysiological model of pressure–volume overload, and in essential hypertensive patients with the same level of left ventricular mass.

Methods. We compared a group of male dialysis patients (D) with two groups: hypertensive patients (H) with comparable left ventricular mass and normotensive healthy subjects as controls (C). The groups (n=15 each) were age- (53±9 years) and gender-matched. Quantitative analysis of echocardiographic digitalized imaging was performed to calculate the mean grey level (MGL) and cyclic variation index (CVI).

Results. The haemodialysis patients had a significantly lower CVI compared with hypertensives and controls both for septum (D): -2.5±17.4% vs (H); 11.8±17% vs (C); 43.2 ±15.4% (P<0.001) and for posterior wall (D): -10.1±261% vs (H); 14.2±14.7% vs (C); 46.6.2±17.2% (P<0.001). A significant inverse relationship was found between intact parathyroid hormone (iPTH) and CVI.

Conclusion. Abnormalities of two-dimensional echocardiographic grey level distribution are present in both haemodialysis patients and hypertensive patients, but seem unrelated to the degree of echocardiographic hypertrophy. These videodensitometric myocardial alterations are significantly higher in dialysis patients than in hypertensive patients with the same extent of left ventricular hypertrophy. The iPTH level may play a role in the development of the ultrasonic myocardial alterations, which probably represent an early stage of uraemic cardiomyopathy.

Keywords: echocardiography; hypertension; uraemic cardiomyopathy; haemodialysis; videodensitometric ultrasonic tissue characterization


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