{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:41:33Z","timestamp":1791250893050,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,11,14]],"date-time":"2013-11-14T00:00:00Z","timestamp":1384387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patients who demonstrate worsening of cardiac wall motion (<jats:styled-content style=\"fixed-case\">WM<\/jats:styled-content>) during hemodialysis have higher 1\u2010year mortality. We sought to identify risk factors for dialysis\u2010induced <jats:styled-content style=\"fixed-case\">WM<\/jats:styled-content> abnormalities. Additionally, we examined the effects of hemodialysis on other parameters of cardiac function. Forty patients underwent echocardiography directly before dialysis and during the last hour of dialysis (79 dialysis sessions). Candidate predictors for intradialytic worsening of <jats:styled-content style=\"fixed-case\">WM<\/jats:styled-content> included age, a history of heart failure (<jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>) or coronary artery disease, changes in blood pressure or heart rate, high sensitivity cardiac troponin <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>\u2010terminal brain natriuretic peptide. Among 40 patients, <jats:styled-content style=\"fixed-case\">WM<\/jats:styled-content> worsened segmentally in eight patients (20%), worsened globally in one patient (3%), and improved segmentally in four patients (10%). Diastolic function worsened in 44% of patients, and left ventricular ejection fraction was largely unchanged during dialysis. The case of globally worsened <jats:styled-content style=\"fixed-case\">WM<\/jats:styled-content> occurred in the setting of intradialytic hypertension in a patient without <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>. Surprisingly, history of coronary artery disease, hemodynamics, and serologic factors were not associated with worsened segmental <jats:styled-content style=\"fixed-case\">WM<\/jats:styled-content> during dialysis. After adjustment for history of coronary artery disease and other cardiac risk factors, patients with a history of <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> had a threefold higher risk of worsening segmental <jats:styled-content style=\"fixed-case\">WM<\/jats:styled-content> during dialysis (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 3.1, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> [1.1, 9], p\u2009=\u20090.04). In conclusion, patients with a history of clinical <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content> were at higher risk of intradialytic worsening of segmental <jats:styled-content style=\"fixed-case\">WM<\/jats:styled-content>. Further studies are needed to determine the mechanism of this association and whether cardioprotective medications could ameliorate this adverse cardiac effect of hemodialysis.<\/jats:p>","DOI":"10.1111\/hdi.12111","type":"journal-article","created":{"date-parts":[[2013,11,14]],"date-time":"2013-11-14T08:27:05Z","timestamp":1384417625000},"page":"396-405","source":"Crossref","is-referenced-by-count":13,"title":["Determinants of hemodialysis\u2010induced segmental wall motion abnormalities"],"prefix":"10.1111","volume":"18","author":[{"given":"Ruth F.","family":"Dubin","sequence":"first","affiliation":[{"name":"Department of Medicine\/Nephrology San Francisco VA Medical Center\/University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis L.","family":"Beatty","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Cardiology San Francisco VA Medical Center\/University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Teerlink","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Cardiology San Francisco VA Medical Center\/University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson B.","family":"Schiller","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Cardiology San Francisco VA Medical Center\/University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann F.","family":"Bolger","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Cardiology San Francisco General Hospital\/ University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Alokozai","sequence":"additional","affiliation":[{"name":"Cardiocore  South San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen A.","family":"Peralta","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Nephrology San Francisco VA Medical Center\/University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten L.","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Nephrology San Francisco VA Medical Center\/University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,11,14]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"USRDS.Ch. 4: Cardiovascular Disease in Patients with End\u2010Stage Renal Disease 2011. 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