Author + information
- Ziya Şimşek1,
- Muhammet Hakan Taş1,
- Emrah İpek2,
- Yusuf Bilen3,
- Erdem Çankaya3,
- Şule Karakelleoğlu1 and
- Hüseyin Şenocak1
Interatrial block (IAB) connotes a P wave duration ≥110 msec on electrocardiography (ECG). P-terminal force corresponds to a biphasic P wave with its terminal negative phase ≥40 msec x mm in V1 derivation on ECG. IAB and P-terminal force are closely related parameters and they are accepted as predictors for left atrial dysfunction, left atrial dilatation, atrial fibrillation and strokes. Left atrial functions in chronic haemodialysis patients becomes worse in the course of time because of long standing pressure and volume overload. The aim of this study is to evaluate the relationship between IAB, P-terminal force and left atrial functions.
Patients and Methods
68 chronic haemodialysis patients and 60 control subjects were included in the study. Haemodialysis group had 42±13.5 months dialysis period. Conventional echocardiography and left atrial dynamic functions were measured in all cases. The subjects with IAB and P-terminal force on ECG were identified.
Demographic, electrocardiographic and echocardiographic data of study and control groups is presented in Table 1. Left ventricular size, wall thickness and left atrial diameters were significantly greater in haemodialysis patients than the control group (p<0.001). 42 (62%) patients had IAB (≥110 msec) and 45 (66%) patients had P-terminal force (≥40 msecxmm) in the haemodialysis group. Left atrial reservoir, conduit and pump functions were significantly lower in the haemodialysis group than the control group (p<0.001) (Table 2).
This study showed that decreased left atrial functions in chronic haemodialysis patients are closely correlated with IAB and P-terminal force.
|Haemodialysis group (n=68)||Control group (n=60)||P-value|
|SBP (mm Hg)||135±15||125±15||0.11|
|DBP (mm Hg)||82±12||74±11||0.25|
|LVEF Simpson's (%)||59.9±9.5||62.1±8.4||0.12|
|Interatrial block (≥110 msec)(n, %)||42(62)||0||<0.001|
|P-terminal force (n, %)||45 (66)||8 (13)||<0.001|
|Reservoir function (%)||42.8±7.8||54.8±4.3||<0.001|
|Conduit function (%)||17.7±4.5||33.4±3.9||<0.001|
|Pump function (%)||35.8±6.5||46.6±6.4||<0.001|
SBP: Systolic blood pressure, DBP: Diastolic blood pressure, LVEDd: Left ventricular end diastolic diameter, LVESd: Left ventricular end systolic diameter, IVSd: Interventricular septum diastolic diameter, LVEF: Left ventricular ejection fraction, LA: Left atrial diameter
|Interatrial block (+) (n=42)||Interatrial block (-) (n=26)||P-value|
|Conduit function (%)||15.8±3.5||21.2±5.1||<0.001|
|Pump function (%)||31.4±4.6||39.4±7.2||<0.001|
|Left atrial diameter (mm)||46.8±5.6||38.4±3.9||<0.001|
|P-terminal force (+) (n=45)||P-terminal force (-) (n=23)|
|Conduit function (%)||15.9±3.7||20.7±5.2||<0.001|
|Pump function (%)||32.5±5.2||39.8±7.1||<0.001|
|Left atrial diameter (mm)||45.5±5.7||39.5±5.5||<0.001|