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

  • Nephrology - Original Paper
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Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusions

Increased inflammation might be a risk factor of AEMD and LA mechanical dysfunction in ESRD patients.

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Acknowledgments

Authors also do not have any relationships with pharmaceutical companies or other entities such as employment contracts, consultancy, advisory boards, speaker bureaus, membership of Board of Directors, stock ownership.

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Authors and Affiliations

  1. Department of Internal Medicine, Erzincan University Mengucek Gazi Training and Research Hospital, Erzincan, Turkey

    Levent Demirtas

  2. Division of Nephrology, Department of Internal Medicine, School of Medicine, Konya Necmettin Erbakan University, 42080, Konya, Turkey

    Kultigin Turkmen

  3. Department of Cardiology, Erzincan University Mengucek Gazi Training and Research Hospital, Erzincan, Turkey

    Mutlu Buyuklu

  4. Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey

    Ismail Kocyigit

  5. Department of Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey

    Ozcan Orscelik

Authors
  1. Levent Demirtas
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  2. Kultigin Turkmen
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Correspondence to Kultigin Turkmen.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Demirtas, L., Turkmen, K., Buyuklu, M. et al. Atrial electromechanical delay and left atrial mechanical functions in hemodialysis and peritoneal dialysis patients. Int Urol Nephrol 48, 781–789 (2016). https://doi.org/10.1007/s11255-016-1238-7

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  • DOI: https://doi.org/10.1007/s11255-016-1238-7

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