Assessment of atrial electromechanical delay and left atrial mechanical functions in chronic kidney disease

Abstract

The risk of atrial fibrillation (AF) development was revealed to be increased in patients with end-stage renal disease (ESRD) Elongation of the time of atrial electromechanical delay (AEMD) is a famous typical of the atrium. AEMD is a risk factor for AF development and it could be associated with chronic kidney disease (CKD). The aim of our study is to examine mechanical functions of the left atrium (LA) and AEMD times in ESRD. A total of 86 participant, 46 with ESRD and 40 as the control group, were included in the study. The demographical and laboratory information were documented. Echocardiographic dimensions were achieved in all patients. Left atrial mechanical functions and AEMD durations were calculated. Demographic and laboratory characteristics of the groups were similar except the mean diastolic blood pressure, hemoglobin, creatinine, glucose, uric acid, calcium and potassium levels. The echocardiographic assessment exposed that the ventricular septal thickness (12.7±1.5 vs. 10.4±1.5, p<0.001), posterior wall thickness (12.6±1.6 vs. 10.1±1.9, p<0.001), LA dimension (40.9±5.3 vs.34.6±2.6, p<0.001) and diastolic parameters decreased in the ESRD group when compared to the control group; also, LA volumes, mechanical functions, inter atrial EMD (33.2±9.1 vs. 22.7±7.7, p<0.001), intra-right-EMD (18.5±7.7 vs. 13.2±6.4, p=0.001) and intra-left-EMD (18.5±7.7 vs. 13.7±5.7, p=0.002) were also different between groups. (p<0.005) The correlation analysis showed that serum ferritin levels were correlated with AEMD. We found deteriorated LA functions and elongation in the times of AEMD in the ESRD group compared with the control group. Additionally, we found positive correlation between ferritin levels and AEMD. This result show that AEMD might be used to predict the risk of development of AF in patients with ESRD.