P1294Evaluation of right atrium mechanics and relation with loading conditions by speckle tracking echocardiography.

Abstract

The aim of this study is to evaluate the right atrial (RA) mechanics and change in echocardiographic parameters used for assessment of RA by examining the end stage kidney patients before and after the hemodialysis (HD). Patients between 18 and 85 years of age, receiving HD for at least 6 months were included. The echocardiographic images were obtained before and after hemodialysis therapy. Two-dimensional speckle tracking strain analysis was performed for right atrium in 62 patients. Reference points for analysis are set on the "P" waves. RA reservoir, conduit and contraction phase longitudinal strain (Figure 1) and strain rates (Figure 2) were calculated. The changes in echocardiographic methods before and after hemodialysis were examined. Correlation between volume depletion and change in echocardiographic parameters were calculated. 62 patients (49.7 ± 16.9 years of age, 22 women) were included in study. The mean volume of ultrafiltration was 2958.12 ± 1050.5 ml . The chamber sizes RA are decreased after hemodialysis (RA major diameter; 4.74 ± 0.62 cm vs. 4.46 ± 0.54 cm p<0.001, RA area; 13.8 ± 3.0 cm2 vs. 10.6 ± 2.8 cm2 p<0.001). Two dimensional speckle tracking analysis showed that; RA reservoir phase strain (% 45.60 ± 10.8 vs. % 38.15 ± 8.11 p<0.001). RA conduit phase strain rate (-1.46 ± 0.82 s-1 vs. -1.2 ± 0.56 s-1 p<0.001) measurements are volume dependent. RA reservoir phase strain rate (2.25 ± 0.65 s- vs. 2.5 ± 0.54 s-1 p:0.091) RA contraction strain (% -16.73 ± 6.8 vs. % -16.35 ± 7.1 p:0.835) and RA contraction strain rate (-2.15 ± 0.95 s-1 vs. -2.21 ± 0.72 s-1 p:0.596) are volume independent parameters. RA reservoir phase strain (r=0.332. p:0.008) showed significant correlation with the ultra filtrated volume. Strain rates of RA reservoir phase and RA contraction and RA contraction strain are found to be volume independent measurements obtained by speckle tracking. Explaining RA mechanics with echocardiography is an easy and repeatable assessment which also elucidates more about cardiac pathophysiology and hemodynamics of patients. Moreover defining novel volume independent parameters for evaluation of RA would contribute to clinical perspectives of patients. Abstract P1294 Figure.