Abstract: SA-PO877
Intradialytic Exercise Preconditioning: The Effect on Myocardial Stunning
Session Information
- Dialysis: Cardiovascular, BP, Volume
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Penny, Jarrin D., University of Western Ontario, London, Ontario, Canada
- Salerno, Fabio R., University of Western Ontario, London, Ontario, Canada
- Brar, Ranveer Singh, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
- Garcia, Eric, University of Manitoba, Winnipeg, Manitoba, Canada
- Rossum, Krista Frances, University of Manitoba, Winnipeg, Manitoba, Canada
- McIntyre, Christopher W., University of Western Ontario, London, Ontario, Canada
- Bohm, Clara, University of Manitoba, Winnipeg, Manitoba, Canada
Background
Exercise preconditioning provides immediate protection against cardiac ischemia in clinical and pre-clinical studies. Intradialytic exercise (IDE) has been utilized to improve functional status in individuals receiving HD. The effect of intradialytic exercise on myocardial stunning is unknown.
Methods
19 adult patients participating in a clinical IDE program were evaluated over 2 HD sessions (control visit - no exercise, exposure visit - exercise). Echocardiography was performed, pre-HD, post exercise and at peak HD stress in each visit . Longitudinal strain (LS) for 12 left ventricular segments were generated using speckle-tracking software [EchoPac, GE], to assess the presence of HD-induced regional wall motion abnormalities (RWMA), indicative of myocardial stunning (>20% reduction in LS in two or more segments).
Results
Mean age was 59.2 and participants were 40% female with median dialysis vintage of 3.8 years. The number of stunned segments at usual exercise time was 4.5 (SD2.6) and 3.9 (SD2.8) in the control and exercise groups, respectively; p=0.168. The number of stunned segments at peak HD stress was 5.8 (SD2.7) and 4.0 (SD 1.8) in the control and exposed groups, respectively; p=0.012. Mean change in number of stunned segments post exercise between control and exposure sessions was -0.95 (SD 2.88). Mean change in number of stunned segments at peak HD was -1.8 (SD 2.8).
Conclusion
IDE significantly reduced HD-induced myocardial stunning at peak HD stress and was not associated with a reduction in intradialytic hypotension.
Number of RWMA at each echo timepoint
(BL = baseline, TE = time of exercise, PS = peak stress)
Mean blood pressures