Estimation of left ventricular filling pressure
in children on hemodyalisis


M. Djukic, I. Jovanovic, Lj. Šulovic, I. Stefanovic, M. Dabetic, T. Ilisic.

University Children’s Hospital, Belgrade, Serbia


Introduction: The ratio of the early transmitral inflow velocity and early diastolic mitral annular velocity (E/Em) can be used to estimate LV filling pressure (LVFP).
Left ventricular filling pressure is increased in children undergoing hemodialysis, due to left ventricular pressure and volume overload.


Objective: To compare LVFP using E/Em ratio in healthy children and children undergoing HD (before and after procedure) and to estimate influence of volume and pressure changes after HD on LVFP.


Method: Forty children were studied (20 undergoing HD and 20 healthy), of similar age and body composition.
Doppler echocardiography was used to measure E velocity. Em was measured using pulsed tissue Doppler echocardiography. E/Em was then calculated.


Results: E/Em ratio before haemodyalisis was 8.58 +/- 1.47, 8.01 +/- 2.02 after hemodyalisis, and 7.11 +/- 0.97 in healthy children. Differences in E/Em values among three groups were shown in table.

Conclusion: LVFP was significantly higher in children before HD comparing to healthy children. There was no significant diffrence in LVFP between children after HD and healthy children. Diastolic function of LV was significantly improved after HD due to volume and systolic unload of LV.