Assessment of right ventricular dysfunction in end-stage renal disease patients on maintenance haemodialysis by cardiac magnetic resonance imaging.

PURPOSE: To assess right ventricular (RV) dysfunction in end-stage renal disease (ESRD) patients on maintenance haemodialysis (HD) by cardiac magnetic resonance (CMR) imaging and determined the risk factors associated with RV dysfunction.

MATERIALS AND METHODS: Fifty ESRD patients on maintenance HD and 16 age- and gender-matched healthy individuals were prospectively enrolled and underwent CMR imaging. Left ventricular (LV) and RV function parameters, including end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF), were measured and compared. Independent sample t-test and Mann-Whitney U-test were used to compare the differences between healthy individuals and ESRD patients. Pearson correlation and multiple linear regression analyses were used to assess risk factors associated with RV dysfunction.

RESULTS: Significantly lower RVEF and LVEF were observed in ESRD patients than in the control group (all p < 0.001). RVEDV, RVESV and RVSV in ESRD patients were also lower than those in the control group (all p < 0.05). Meanwhile, higher LVESV, LV mass and interventricular septum thickness were found in ESRD patients than in the control group (all p < 0.05). RVEF was positively correlated with LVEF (r = 0.37, p = 0.008) and negatively correlated with the duration of renal insufficiency (r = -0.53, p < 0.001) and dialysis (r = -0.63, p < 0.001). Moreover, multiple linear regression analyses revealed that the duration of dialysis and LVEF were independently associated with decreased RVEF (adjusted R2  = 0.53, p < 0.001).

CONCLUSIONS: In ESRD patients on maintenance HD, RV function was impaired and associated with the deterioration of LV function. More importantly, the duration of dialysis was considered as a risk factor independently associated with RV dysfunction.