{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:32:00Z","timestamp":1785407520543,"version":"3.56.0"},"reference-count":71,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006334","name":"Jan Kochanowski University","doi-asserted-by":"publisher","award":["SUPB.RN.23.025"],"award-info":[{"award-number":["SUPB.RN.23.025"]}],"id":[{"id":"10.13039\/501100006334","id-type":"DOI","asserted-by":"publisher"}]},{"award":["SUPB.RN.23.025"],"award-info":[{"award-number":["SUPB.RN.23.025"]}],"id":[{"id":"https:\/\/ror.org\/00krbh354","id-type":"ROR","asserted-by":"publisher"}]},{"name":"University of Rzeszow"},{"id":[{"id":"https:\/\/ror.org\/03pfsnq21","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010621","name":"Medical University of Lublin","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010621","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/016f61126","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Cardiovascular complications remain the leading cause of mortality among patients with end-stage renal disease (ESRD) treated with maintenance hemodialysis (HD). Global longitudinal strain (GLS) is a sensitive echocardiographic marker of left ventricular systolic dysfunction that enables the detection of transient contractile abnormalities consistent with intradialytic myocardial stunning. This study aimed to assess intradialytic GLS dynamics during a single HD session and to identify predictors of GLS deterioration. Methods: Forty-three patients were enrolled. Transthoracic echocardiography, electrocardiography, and pulse wave analysis were performed before HD, at mid-session, and after HD. Biochemical assessment included, among others, plasma osmolality, electrolytes, and biomarkers of oxidative stress and endothelial dysfunction. Results: Three distinct intradialytic GLS trajectories were identified: GLS worsening (GLSw, 46.5%), GLS stable (GLSs, 34.9%), and GLS improvement (GLSi, 18.6%). In the GLSw group, independent predictors of GLS deterioration included a decrease in left atrial volume index (LAVI, p = 0.0002), an increase in left ventricular end-systolic volume index (LVESVI, p = 0.0067), diabetes mellitus (p = 0.0094), and an increase in the malondialdehyde-to-creatinine ratio (MDA\/CREA, p = 0.0055). In the GLSi group, GLS improvement was associated with a decrease in plasma osmolality (p = 0.0326) and asymmetric dimethylarginine (ADMA, p = 0.0279), as well as an increase in the subendocardial viability ratio index (SEVRI, p = 0.0004) and caspase-1 (p = 0.0005). Conclusions: Intradialytic GLS trajectories are heterogeneous and reflect individual susceptibility to GLS deterioration. Modifiable adverse factors likely include oxidative stress, osmotic stress, fluid overload, uremic toxin- and ion-disturbance-related stress, and impaired coronary microvascular reserve. Future prospective studies are needed.<\/jats:p>","DOI":"10.3390\/jcm15083004","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:25:30Z","timestamp":1776255930000},"page":"3004","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of Hemodialysis-Induced Acute Global Longitudinal Strain Deterioration and Their Predictors"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0356-8211","authenticated-orcid":false,"given":"Agnieszka","family":"Bociek","sequence":"first","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland"},{"name":"Department of Nephrology and Dialysis, Specialist Clinic County Hospital, 37-450 Stalowa Wola, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0121-4487","authenticated-orcid":false,"given":"Katarzyna","family":"Starzyk","sequence":"additional","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6933-2392","authenticated-orcid":false,"given":"Marcin","family":"Jadach","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Dialysis, Specialist Clinic County Hospital, 37-450 Stalowa Wola, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamila","family":"Bo\u0142tu\u0107-Dziugie\u0142","sequence":"additional","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9658-5909","authenticated-orcid":false,"given":"Joanna","family":"Roskal-Wa\u0142ek","sequence":"additional","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland"},{"name":"Ophthalmology Clinic, Voivodeship Regional Hospital, 25-736 Kielce, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6617-0852","authenticated-orcid":false,"given":"Agnieszka","family":"Gala-B\u0142\u0105dzi\u0144ska","sequence":"additional","affiliation":[{"name":"Collegium Medicum, University of Rzeszow, 35-310 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0449-2375","authenticated-orcid":false,"given":"Wojciech","family":"D\u0105browski","sequence":"additional","affiliation":[{"name":"First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8194-1723","authenticated-orcid":false,"given":"Andrzej","family":"Jaroszy\u0144ski","sequence":"additional","affiliation":[{"name":"Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland"},{"name":"Department of Nephrology and Dialysis, Specialist Clinic County Hospital, 37-450 Stalowa Wola, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"853","DOI":"10.33963\/KP.a2022.0165","article-title":"Evaluation of Left Ventricular Functions in Individuals with Iron Deficiency Anemia by Three-Dimensional Echocardiography and Strain Imaging Method","volume":"80","author":"Cebeci","year":"2022","journal-title":"Pol. 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