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Echocardiographic assessment of aortic stiffness and cardiac function in end-stage renal disease patients undergoing hemodialysis

Year: 2025

Type: article

Abstract: Introduction: End-stage renal disease (ESRD) is strongly associated with increased cardiovascular morbidity and mortality, with aortic stiffness emerging as a key predictor of adverse outcomes. Echocardiographic assessment of aortic stiffness and cardiac function provides valuable insights into these vascular changes. However, limited research has explored the extent of aortic stiffness and its clinical implications in ESRD patients. This study aimed to assess aortic stiffness and cardiovascular function in ESRD patients using echocardiographic parameters, including aortic strain, distensibility, and stiffness index. Objectives: Our study aimed to evaluate aortic stiffness by measuring aortic strain, aortic distensibility, and the aortic stiffness index, as well as assess cardiac function using echocardiographic parameters—including left ventricular ejection fraction (LVEF), isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT), ejection time (ET), and TEI index—between ESRD patients and a control group to determine the extent of cardiovascular alterations associated with renal dysfunction. Patients and Methods: In this comparative observational study, a total of 323 patients were enrolled, comprising 173 ESRD patients and 150 controls. Echocardiographic assessments were conducted to evaluate aortic stiffness index, aortic strain, aortic distensibility, and cardiac function parameters such as LVEF, IVRT, IVCT, and TEI index. Patients were screened based on estimated glomerular filtration rate (eGFR) and underwent echocardiographic evaluation using the Mindray DC-60 machine by a single operator. Results: ESRD patients demonstrated significantly higher aortic stiffness (P=0.030) and reduced aortic strain and distensibility (P<0.000) compared to controls, indicating impaired vascular compliance. Additionally, ESRD patients had lower LVEF (P<0.000), prolonged IVRT (P<0.000), IVCT (P=0.009), and ET (P=0.001), reflecting compromised myocardial function. No significant differences were observed in left atrial diameter, systolic aortic diameter, or E/A ratio. Conclusion: Aortic stiffness is significantly increased in ESRD patients undergoing hemodialysis, correlating with impaired cardiac function and vascular remodeling. These findings highlight the importance of routine cardiovascular assessment in ESRD patients to improve risk stratification and clinical management. Further large-scale, longitudinal studies are needed to validate these findings and explore potential therapeutic strategies.

Source: Journal of Nephropathology

DOI: 10.34172/jnp.2025.25554