慢性肾病患者心房机电延迟和左心房机械功能的评估

Gökay Nar, Aydın Güçlü, S. Inci, G. Aksan, A. Içli, R. Nar
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摘要

终末期肾病(ESRD)患者房颤(AF)发生的风险增加,心房机电延迟(AEMD)时间延长是心房的一个著名特征。AEMD是房颤发展的一个危险因素,它可能与慢性肾脏疾病(CKD)有关。我们研究的目的是检查ESRD患者左心房(LA)的力学功能和AEMD时间。研究共纳入86例参与者,其中46例为ESRD, 40例为对照组。记录了人口统计和实验室信息。所有患者均获得超声心动图检查结果。计算左心房力学功能和AEMD持续时间。除了平均舒张压、血红蛋白、肌酐、葡萄糖、尿酸、钙和钾水平外,两组的人口统计学和实验室特征相似。超声心动图评估显示,与对照组相比,ESRD组室间隔厚度(12.7±1.5比10.4±1.5,p<0.001)、后壁厚度(12.6±1.6比10.1±1.9,p<0.001)、LA尺寸(40.9±5.3比34.6±2.6,p<0.001)和舒张参数降低;两组间LA容积、力学功能、心房间EMD(33.2±9.1比22.7±7.7,p<0.001)、右内EMD(18.5±7.7比13.2±6.4,p=0.001)、左内EMD(18.5±7.7比13.7±5.7,p=0.002)也存在差异。(p<0.005)相关性分析显示血清铁蛋白水平与AEMD相关。我们发现,与对照组相比,ESRD组LA功能恶化,AEMD时间延长。此外,我们发现铁蛋白水平与AEMD呈正相关。提示AEMD可用于预测ESRD患者发生房颤的风险。
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Assessment of atrial electromechanical delay and left atrial mechanical functions in chronic kidney disease
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.
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