ATRIAL ELECTRICAL AND MECHANICAL DYSFUNCTION IN NON-DIABETIC, NON-HYPERTENSIVE HEMODIALYSIS PATIENTS

作者：Tekce Hikmet^*; Ozturk Serkan; Aktas Gulali; Tekce Buket Kin; Erdem Alim; Uyeturk Ugur; Ozyasar Mehmet; Duman Tuba Taslamacioglu; Yazici Mehmet

来源：Acta Medica Mediterranea, 2014, 30(1): 21-26.

• Atrial conduction time
• atrial fibrillation
• atrial mechanical functions
• atrial remodeling
• electromechanical delay
• hemodialysis

Background: Abnormalities in atrial conduction times and mechanical functions are considered as independent predictors of atrial fibrillation. However, there is no data in literature about functional parameters and electromechanical delay intervals in nondiabetic, non-hypertensive hemodialysis (HD) patients. We aimed to study atrial electromechanical conduction times and mechanical functions in this population.
Methods: Forty-two non-diabetic, normotensive hemodialysis patients and age and sex matched control subjects have been enrolled in the study. Standard and Tissue Doppler Echocardiography have been performed before mid-week dialysis session for HD group and on admission for control group.
Results: PA(lateral,), PA(septum) durations of the hemodialysis group were significantly longer than control group (70.6 +/- 9.1 vs 55.3 +/- 2.7, 50.8 +/- 5.2 vs 44.4 +/- 2.1; p<0.01). Interatrial and left-right intraatrial electromechanical delay intervals were significantly longer in hemodialysis group compared to controls (31.6 +/- 7.2 vs 18.0 +/- 2.6, 19.8 +/- 7.9 vs 10.9 +/- 2.7, 11.8 +/- 5.1 vs 7.1 +/- 1.2, respectively; all p<0.01). Measurements of left atrial diameter, maximum, minimum and before atrial systole, volumes and passive-active emptying volumes were both elevated in hemodialysis group compared to controls (all p<0.01).
Conclusions: This is the first study enlightening deterioration in atrial mechanical and electromechanical functions in nondiabetic, non-hypertensive HD population. Results of the present study reflect not only negative effects of structural remodeling, which has been mentioned in previous studies in literature, but also negative effects of electrical remodeling. Prolonged inter- and intra-atrial electromechanical delay intervals should be the underlying pathophysiological factors increasing the rate of atrial fibrillation in hemodialysis population.

• 出版日期2014