International Urology and Nephrology

, Volume 48, Issue 5, pp 781–789

Atrial electromechanical delay and left atrial mechanical functions in hemodialysis and peritoneal dialysis patients

  • Levent Demirtas
  • Kultigin Turkmen
  • Mutlu Buyuklu
  • Ismail Kocyigit
  • Ozcan Orscelik
Nephrology - Original Paper



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.


Left intra-atrial electromechanical delay time Left atrium mechanical function Inflammation Hemodialysis Peritoneal dialysis 


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Levent Demirtas
    • 1
  • Kultigin Turkmen
    • 2
  • Mutlu Buyuklu
    • 3
  • Ismail Kocyigit
    • 4
  • Ozcan Orscelik
    • 5
  1. 1.Department of Internal MedicineErzincan University Mengucek Gazi Training and Research HospitalErzincanTurkey
  2. 2.Division of Nephrology, Department of Internal Medicine, School of MedicineKonya Necmettin Erbakan UniversityKonyaTurkey
  3. 3.Department of CardiologyErzincan University Mengucek Gazi Training and Research HospitalErzincanTurkey
  4. 4.Division of Nephrology, Department of Internal MedicineErciyes University Medical FacultyKayseriTurkey
  5. 5.Department of CardiologyErciyes University Medical FacultyKayseriTurkey

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