維持透析患者における心機能 ： 経年変化に関する研究

Abstract

The cardiovascular functions of 64 patients on maintenance hemodialysis were evaluated by non-invasive methods (mechanocardiographic and echocardiographic method) during 2 to 5 years' follow-up period. The patients were divided into two groups according to prognosis : Group S : survivors (54 patients) ; Group D : dead (10 patients). According to blood pressure control they were also divided into two groups : Group N : well controlled (47 patients) ; Group HT : poorly controlled (17 patients). The results from this study were as follows : (1) In Group S, mean blood pressure (MBP), left ventricular diastolic dimension (LVDd) and corrected pre-ejection period (PEPc) decreased during 5 years' follow-up period. (2) In Group D, MBP and LVDd showed no significant changes during 2 years' follow-up period, but the ratio of ejection time to pre-ejection period (ET/PEP) tended to decrease during this period. (3) After 2 years, ET/PEP was significantly lower in Group D than in Group S. (4) In Group HT, left ventricular wall thickness (LVTh) and left ventricular mass (LVmass) increased during 5 years' follow-up period, and PEPc had tendency to decrease during this period. (5) After 5 years, ET/PEP was significantly lower in Group HT than in Group N, and LVTh and LVmass were greater in Group HT than in Group N. These findings suggest that left ventricular function in normotensive patients on maintenance hemodialysis might decrease preload and afterload, and that prolonged hypertension might decrease left ventricular function and produce left ventricular hypertrophy.