Cleveland Clinic, United Arab Emirates
Keynote: J Clin Exp Cardiology
Patients with end-stage renal disease requiring dialysis are at increased risk for development of heart failure (HF). Factors that may contribute to HF in the dialysis patient include fluid overload, left ventricular diastolic dysfunction, LV systolic dysfunction, and valvular heart disease. A high-output state caused by shunting through hemodialysis arteriovenous access can also precipitate HF. A proposed functional classification scheme was developed specifically for patients with end-stage renal disease (ESRD) by the Acute Dialysis Quality Initiative (ADQI) XI Workgroup. The cardiac evaluation of dialysis patients should address whether HF is present, what type of HF is present (HFrEF; LVEF â?¤40 percent, HF with midrange ejection fraction HFmrEF; LVEF 41 to 50 percent, HF with preserved ejection fraction HFpEF; LVEF >50 percent, HF from valve disease, and identification of contributing factors. The approach to management of HF in the dialysis patient varies depending on the clinical presentation.
Samer Ellahham has served as Chief Quality Officer and Global Healthcare Leader for SKMC since 2009. He is a Board-certified Internist, Cardiologist and Vascular Medicine Senior Consultant and continues to care for patients. He received his Undergraduate Degree in Biology and his MD from the American University of Beirut, Beirut, Lebanon. He has obtained his fellowship in Cardiology at the Medical College of Virginia (MCV) in USA. He has worked in Washington DC in several clinical and leadership positions before moving to UAE in 2008. He led the First AHA GWTG Heart Failure Initiative outside US and was the recipient of the AHA GWTG Award in Washington, DC. He is the champion of the AHA GWTG in the region. He continues to be an active Clinician. He is board certified in internal medicine, vascular medicine, Cardiology and quality. He was recently recertified in 2017 by the American Board of Cardiology (ABIM). He is a Fellow of the American College of Cardiology and key member in Heart Failure and Transplant, Adult Congenital and Pediatric Cardiology, Cardio-oncology and Peripheral Vascular Disease sections.