Effect of haemodialysis on left atrial mechanical function in patients with chronic renal failure.
OBJECTIVE
The aim of this study was to investigate the potential effects of haemodialysis on left atrial (LA) mechanical functions in patients with chronic renal failure.


METHODS
Thirty-two patients with chronic renal failure (mean age 42.8 +/- 19.6 years) were included in this study. LA volumes were determined echocardiographically at the time of mitral valve opening (maximal,Vmax), at the onset of atrial systole (p wave at the electrocardiography = Vp) and at the mitral valve closure (minimal, Vmin) according to the biplane area-length method in apical 4-chamber and 2-chamber view. All volumes were corrected to the body surface area, and the following left atrial emptying functions were calculated. LA passive emptying volume = Vmax - Vp, LA passive emptying fraction = LA passive emptying volume/Vmax. Conduit volume = LV stroke volume-(Vmax - Vmin), LA active emptying volume = Vp Vmin. LA active emptying fraction = LA active emptying volume/Vp, LA total emptying volume = (Vmax - Vmin), LA total emptying fraction = LA total emptying volume/Vmax.


RESULTS
Mean fluid removal was 1,875 +/- 812 milliliter. There was no difference between in the LA passive emptying volume before and after dialysis (10.83 +/- 7.44 vs. 11.47 +/- 7.73 cm3/m2, p > 0.05). Conduit volume (from 15.30 +/- 10.68 to 10.31 +/- 6.83 cm3/m2, p < 0.05), LA active emptying volume (from 12.61 +/- 6.39 to 9.25 +/- 4.40 cm3/m2, p < 0.005), LA total emptying volume (from 23.44 +/- 8.52 to 20.72 +/- 8.58 cm3/m2, p < 0.05), LA maximal volume (from 39.44 +/- 14.07 to 28.89 +/- 11.80 cm3/m2, p < 0.001), LA minimal volume (from 15.99 +/- 9.70 to 8.17 +/- 4.52 cm3/m2, p < 0.001), and the volume at the onset of atrial systole (from 28.61 +/- 10.36 to 17.42 +/- 7.20 cm3/m2, p < 0.001) decreased significantly after the haemodialysis session, whereas LA passive emptying fraction (from 0.27 +/- 0.14 to 0.38 +/- 0.14%, p < 0.001), LA active emptying fraction (from 0.46 +/- 0.18 to 0.53 +/- 0.17%, p < 0.05), LA total emptying fraction (from 0.61 +/- 0.14 to 0.72 +/- 0.09%, p < 0.001) increased significantly after haemodialysis.


CONCLUSIONS
The results of this study suggest that left atrial mechanical functions improve after haemodialysis in patients with chronic renal failure.
Yilmaz
Mustafa
M
Department of Cardiology, Medical School Hospital, Ataturk University, Erzurum, Turkey. kardiyomustafa@hotmail.com
Erol
Mustafa Kemal
MK
Cetinkaya
Ramazan
R
Alp
Necip
N
D000328:Adult; D016279:Atrial Function, Left / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis