Korean Journal of Nephrology 1983;2(1):41-48.

말기 신장질환에서의 초음파 심음향도 연구

김문재 , 조승연 , 이호영 , 정석호

Abstract

Echocardiography (ECHO) has proved to be of great help in cardiac evaluation of symptomatic patients with end-stage renal disease (ERD) not only in diagnosing the presence and the extent of pericardial effusion, but also assessing the function of left ventricle (LV). Myocardial and pericardial diseases often cause morbidity and motality as potential major complic- ations with ESRD. ECHO examination permits rapid, convenient, and non-invasive detection of changes of LV contractility and pericardial effusion. Sequential ECHOs in individual patient allow for monitoring of LV function and planning the appropriate therapy, and moreover for the exclusion of patients as potential transplant candidates. ECHO has been performed to evaluate pericardial effusion and % fractional shortening (FS) of LV in 34 unselected patients with clinically proven ESRD before dialysis, and an attempt was made to ciassify the ECHO findings into four groups. The results of an analysis are as follows: 1. The patients were divided into four distinct groups according to the combination of LV hypertr- ophy and/or dilatation including: 1) Group N with normaI LV in 5 patients (14.7%); 2) Group H with hypertrophic LV in 15 patients (44.1,); 3) Group D with dilated LV In 6 patients (i7.6;.), and fin- ally 4) Group HD with hypertrophic dilated LV in 8 patients (23.5%). O 23 patients(67.6%) of Group H & HD had hypertrophic change of LV in these series. 2. Pericardial effusions (PE) were present in 16 patints (47.1%) High incidence of PE (83,3%) was noted in Group D with ECHO picture of conge- stive cardiomyopathy, but Group H with hypertrop- hic cardiomyopathy had 26.7% of PE. 3. There was no significant difference of hemat- ocrit among four group. Group H had highest blood pressure (193±43/113±28 mmHg), Group HD & D had high elevated pressure, but Group N had normal pressure. 4. Average of FS for these series was 31.0%. Grovp N had normal % FS (33. 8%) and Group H had 32% of % FS with normal myocardial contra ctility despite prominent hypertrophg of LV, but Graup D and Group HD had slight decreased % FS (27. 3,%,28% respectively).