Echocardiographic Findings in Hemodialysis Pak Armed Forces Med J 2022; 72 (Suppl-3): S678 Echocardiographic Findings in Hemodialysis Patients in a Tertiary Care Hospital Nayab Balqees, Sajjad Hussain, Rizwan Yusuf, Mir Jalal-ud-Din*, Jahanzab Ali**, Tabasum Muzaffar***, Hafsa Khalil****, Shaista Naseem****, Ayesha Sana**** Combined Military Hospital Abbottabad/National University of Medical Sciences (NUMS) Pakistan, *Woman Medical College & Hospital, Abbottabad Pakistan **Armed Cardiac Center, Lahore Pakistan, ***Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan, ****Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan ABSTRACT Objective: To find out the echo abnormalities in a south Asian cohort on maintenance hemodialysis in a tertiary care hospital. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Combined Military Hospital Abbottabad, from Feb 2022 to Apr 2022. Methodology: 57 adult patients on maintenance hemodialysis had a non-contrast transthoracic echocardiographic study recording parameters of left and right ventricular systolic and diastolic function. Results: We had 57 patients. 71.9% (n=41) were male, and females 28.1% (n=16), diabetics 47.4 % (n=27), hypertensives 84.2% (n=48), smoking 28.1% (n=16); 15.8%(n=9) had some form of ischemic heart disease. Left ventricular hypertrophy was noted in 78.9% (n=45) of the entire patient population. 84% (n=48) of hypertensive patients had LVH. Overall, 82% (n=47) of hypertensive patients had some degree of diastolic dysfunction compared to non-hypertensive patients (p<0.0001). Diastolic dysfunction of Grades I, II, III was seen in 35.1%(n=20), 29.8%(n=17), 17.5% (n=10). Mean E/e' ratio was 24.9±15, with 40.3%(n=23) having a value ≥15. The LV systolic dysfunction noted was: Mild 26.3%(n=15), Moderate 19.3%(n=11), Severe 1.8%(n=1). For the medial mitral annular systolic velocity(s’) 19.3%(n=11) had normal s’, while 80.7%(n=46) had reduced s’. The mean Pulmonary artery acceleration time (PA-AT) was was <100 ms in 68.4%(n=39). The mean tricuspid plane systolic excursion (TAPSE) was < 17 mm in 19.3%(n=11) of patients indicating RV systolic dysfunction. The Minimum PASP was 16, max 64, mean 41.5±14mm Hg. Conclusion: In our study of CKD patients on regular hemodialysis, we found high rates of LVH, DD, LV systolic dysfunction, RV systolic function, and pulmonary hypertension. This creates a case for a larger scale study of these patients in a south Asian cohort as well as institution of a screening program in CKD patients on hemodialysis. Keywords: Chronic kidney disease, End-stage renal disease, Hemodialysis, Left ventricular hypertrophy, Mitral annular calcification, Mitral annular velocities. How to Cite This Article: Balqees N, Hussain S, Yusuf R, Din MJ, Ali J, Muzaffar T, Khalil H, Naseem S, Sana A. Echocardiographic Findings in Hemodialysis Patients in a Tertiary Care Hospital. Pak Armed Forces Med J 2022; 72(Suppl-3): S678-682. DOI: https://doi.org/10.51253/pafmj.v72iSUPPL-3.9547 INTRODUCTION Chronic kidney disease (CKD) is defined as abnormalities in renal function characterized by reduc- tion in glomerular filtration rate (GFR) <60 mL/min/ 1.73 m 2 that have been present for >3 months and have an impact on health. 1 CKD and cardiovascular diseases (CVD) share multiple interfaces, especially in patients with diabetes mellitus (DM) and hypertension (HTN). The increased morbidity and mortality in CKD can be due to a wide range of clinical entities. The cardio- vascular consequences of CKD include left ventricular hypertrophy (LVH), Left ventricular (LV) diastolic dysfunction, LV systolic dysfunction due to uremic cardiomyopathy, accelerated calcification in vessels, mitral annulus, 2 aorto-mitral curtain and the aortic valve. CKD also predisposes patients to contrast induced acute kidney injury. Of the 25% of patients who develop a cardiorenal syndrome during hospi- talization for heart failure, approximately one third recover baseline renal function, one third have a residual reduction in eGFR, and the final third have progressive cardiorenal disease resulting in either death or the need for renal replacement therapy. 3 Importantly, the long-term cardiac outcomes in renal patients are worse than the general population. 50% of patients with CKD stage 4 to 5 have CVD, 4 and half of all deaths in patients with CKD 4 to 5 are due to CVD, 5 compared with 26% in controls with normal kidney function. The current gold standard for myocardial tissue characterization in health and disease is Cardiac Magnetic Resonance (CMR). The inherent risk of Nephrogenic systemic fibrosis in patients with chronic kidney diseases precludes the use of Gadolinium in these patients, leaving the field open for echocar- diography for detection of cardiovascular complica- tions and associations of CKD. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Correspondence: Dr Sajjad Hussain, Department of Medicine, Combined Military Hospital, Abbottabad, Pakistan sajjad.hussain.cardiologist@gmail.com Original Article Open Access MISCELLANEOUS