Atrial electromechanical delay and left atrial mechanical functions in hemodialysis and peritoneal dialysis patients
- First Online:
Left atrium (LA) mechanical functions and atrial electromechanical delay (AEMD) times were considered independent predictors of cardiovascular morbidity in general population. Data are scant about these parameters in end-stage renal disease (ESRD) patients receiving hemodialysis (HD) and peritoneal dialysis (PD). We aimed to evaluate AEMD times and LA mechanical functions and associated risk factors in HD and PD patients.
Forty-four healthy individuals, 62 HD and 50 PD patients were enrolled in the study. Echocardiography was performed before midweek dialysis session for HD patients and on admission for PD patients. Data were expressed as mean ± SD. Spearman’s test was used to assess linear associations. Predictors of left intra-atrial EMD time and LA active emptying volume (LAaeV) were assessed by regression analysis.
Left intra-atrial-AEMD times were significantly longer in HD patients compared to PD patients. LAaeV was positively correlated with inter-atrial time, left intra-atrial time, systolic and diastolic BP, calcium and neutrophil-to-lymphocyte ratio (NLR) (r 0.22, p 0.016; r 0.28, p 0.002; r 0.34, p < 0.001; r 0.35, p < 0.001; r 0.37, p < 0.001; r 0.46, p < 0.001, respectively) and negatively correlated with serum uric acid (r −0.31, p 0.013) in ESRD patients. We found positive correlations between left intra-atrial time and LAaeV, LAVmax, LAVp and NLR (r 0.28, p 0.002; r 0.27, p 0.003; r 0.27, p 0.003; r 0.22, p 0.03, respectively) and negative correlations with albumin, uric acid and potassium (r −0.24, p 0.008; r −0.19, p 0.04; r −0.26, p 0.037, respectively). Advanced age, decreased serum albumin and increased NLR were found to be independent predictors of LAaeV; however, only NLR was found to be an independent predictor of AEMD time in this population.
Increased inflammation might be a risk factor of AEMD and LA mechanical dysfunction in ESRD patients.
KeywordsLeft intra-atrial electromechanical delay time Left atrium mechanical function Inflammation Hemodialysis Peritoneal dialysis
- 1.US Renal Data System USRDS (2006) Annual Data Report Bethesda MD, National Institutes of Health, National Institute of Diabetes and Digestive Disease and Kidney DiseasesGoogle Scholar
- 2.Levey AS, Beto JA, Coronado BE, Eknoyan G, Foley RN, Kasiske BL et al (1998) Controlling the epidemic of cardiovascular disease in chronic renal disease: What do we know? What do we need to learn? Where do we go from here? National Kidney Foundation Task Force on Cardiovascular Disease. Am J Kidney Dis 32(5):853–906CrossRefPubMedGoogle Scholar
- 11.Quinones MA, Otto CM, Stoddard M, Waggoner A, Zoghbi WA (2002) Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 15(2):167–184CrossRefPubMedGoogle Scholar
- 13.Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA et al (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18(12):1440–1463CrossRefPubMedGoogle Scholar
- 26.Ahtarovski KA, Iversen KK, Lonborg JT, Madsen PL, Engstrom T, Vejlstrup N (2012) Left atrial and ventricular function during dobutamine and glycopyrrolate stress in healthy young and elderly as evaluated by cardiac magnetic resonance. Am J Physiol Heart Circ Physiol 303(12):H1469–H1473CrossRefPubMedGoogle Scholar