title: Detection of Left Atrium Myopathy Using Two-Dimensional Speckle Tracking Echocardiography in Patients with End-Stage Renal Disease on Dialysis Therapy.
abstract: BACKGROUND
  Left atrium (LA) deformation analysis by two-dimensional speckle tracking echocardiography (2DSTE) has recently been proposed to evaluate left ventricular (LV) filling pressure in dialysis patients.
  
  
  OBJECTIVE
  The purpose of this study was to study the LA function in dialysis patients using two-dimensional speckle tracking echocardiography correlated to prevalence of atrial fibrillation, echocardiographically pulmonary capillary wedge pressure, and right ventricle systolic pressure.
  
  
  METHODS
  Hundred adult patients aged 49.3 ± 13.9 years on regular hemodialysis and 40 healthy individuals were enrolled in the study. Left ventricular dimensions, ejection fraction, and mass index were studied. Left atrium volume index (LAVI) was calculated by dividing left atrium volumes by body surface area. Left ventricle filling pressure was evaluated according to E/E'. Left atrium global systolic strain (LASS) was studied using 2DSTE. Left atrium stiffness was calculated noninvasively based on the ratio of E/E' to LASS. Right ventricle systolic pressure was estimated with the Bernoulli equation formula.
  
  
  RESULTS
  Left atrium diameter, left ventricle indexed mass, mitral (E/E'), and LA stiffness were increased in dialysis group 4.4 ± 0.2 cm, 126.5 ± 24.6 g/m(2) , 16.9 ± 4.4, and 0.5 ± 0.1, respectively, P < 0.001 for all. Left atrium systolic strain was significantly decreased in dialysis patients (26.6 ± 1.9 vs. 33.7 ± 2.1%, P < 0.001). Left atrium stiffness was significantly higher in dialysis patients with atrial fibrillation (AF) compared to those without AF.
  
  
  CONCLUSIONS
  Assessment of LA deformation parameters predicts LV diastolic dysfunction and right ventricle systolic pressure in dialysis patients. Left atrium function in dialysis patients was impaired before the occurrence of left atrium dilatation.
authors.affiliation: Department of Cardiovascular Diseases, Cairo University, Egypt.
authors.forename: Noha
authors.initials: N
authors.lastname: Hassanin
authors.affiliation: Department of Internal Medicine and Nephrology, Cairo University, Egypt.
authors.forename: Alkhateeb
authors.initials: A
authors.lastname: Alkemary
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging; D016279:Atrial Function, Left; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
keywords: atrial fibrillation; hemodialysis; left atrium stiffness; left atrium systolic strain