Myocardial stunning in hemodialysis: What is the overall message?
Article first published online: 18 OCT 2010
© 2010 The Authors. Hemodialysis International © 2010 International Society for Hemodialysis
Volume 14, Issue 4, pages 447–450, October 2010
How to Cite
DORAIRAJAN, S., CHOCKALINGAM, A. and MISRA, M. (2010), Myocardial stunning in hemodialysis: What is the overall message?. Hemodialysis International, 14: 447–450. doi: 10.1111/j.1542-4758.2010.00495.x
- Issue published online: 18 OCT 2010
- Article first published online: 18 OCT 2010
- Manuscript received July 2010; revised July 2010.
Heart failure and cardiovascular events are common in chronic renal failure. Hemodialysis (HD) causes significant hemodynamic changes and hypotension. New evidence based on intradialytic echocardiography demonstrates transient cardiac dysfunction or stunning in majority of chronic HD patients. Over time, this group may progress to chronic heart failure and appears to predict higher cardiovascular events and mortality. Although the exact etiology is unclear, alterations in HD technique and cardiac medications may reduce this complication. We review the current understanding of acute cardiac stunning during HD and present a systematic management algorithm to optimizing overall outcomes in this high-risk population.