Effect of haemodialysis on left atrial mechanical function in patients with chronic renal failure

Abstract

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/Vvmax. 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 1875 ± 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.Conclusion — The results of this study suggest that left atrial mechanical functions improve after haemodialysis in patients with chronic renal failure.