The Prevalence of Atrial Fibrillation and Related Factors Including Anthropometric, Hemodynamic and Echocardiographic Parameters in Patients with Hemodialysis

Abstract

Introduction: Atrial fi brillation is the most common type of arrhythmia. The prevalence of atrial fi brillation is increased in hemodialysis patients. The aim of the present study was to investigate the prevalence of atrial fi brillation and related factors including anthropometric, hemodynamic and echocardiographic parameters in hemodialysis patients. Patients and Methods: We recruited 154 [72 (46.8%) woman, 82 (53.2%) man] hemodialysis patients in this study. Atrial fi brillation was determined electrocardiographically (the P waves was absent and RR intervals were irregular) and the patients were divided into two groups depending on the presence or absence of atrial fi brillation. Transthoracic echocardiography was performed in all patients. Results: There were 7 (4.5%) patients with atrial fi brillation. Although we found that the age, left ventricle end-diastolic diameter, left ventricle end-systolic diameter and left atrial diameter were increased in hemodialysis patients with atrial fi brillation, ejection fraction increased in hemodialysis patients with no atrial fi brillation. Left atrial diameter and left ventricle end-systolic diameter were shown to be independent predictors of atrial fi brillation in hemodialysis patients (p< 0.05). Conclusion: Left atrial diameter and end-systolic left ventricle diameter were independent predictors of atrial fi brillation in hemodialysis patients.

Keywords

• Atrial fi brillation, left atrium, left ventricle, electrocardiography, echocardiography

Hemodiyaliz Hastalarında Atriyal Fibrilasyon Prevalansı ve Bununla İlişkili Antropometrik, Hemodinamik ve Ekokardiyografi k Parametreler

Abstract

Giriş: Atriyal fi brilasyon en sık görülen aritmi tipidir. Atriyal fi brilasyon insidansı hemodiyaliz hastalarında artmıştır. Bu çalışmanın amacı hemodiyaliz hastalarında atriyal fi brilasyon prevalansını ve bununla ilişkili antropometrik, hemodinamik ve ekokardiyografi k parametreleri araştırmaktır. Hastalar ve Yöntem: Toplam 154 [72 (%46.8) kadın, 82 (%53.2) erkek] hemodiyaliz hastası çalışmaya dahil edildi. Elektrokardiyografi de P dalgalarının olmaması ve düzensiz RR intervali varlığında atriyal fi brilasyon tanısı konuldu ve hastalar atriyal fi brilasyon olup olmamasına göre iki gruba ayrıldı. Tüm hastalara transtorasik ekokardiyografi yapıldı. Bulgular: Hastaların 7 (%4.5)'sinde atriyal fi brilasyon mevcuttu. Atriyal fi brilasyon olan grupta yaş, sol ventrikül diyastol sonu çapı, sol ventrikül sistol sonu çapı ve sol atriyum genişliği daha fazla iken; atriyal fi brilasyon olmayan grupta ejeksiyon fraksiyon daha yüksekti. Hemodiyaliz hastalarında sol atriyum çapı ve sol ventrikül sistol sonu çapı atriyal fi brilasyonu belirlemede bağımsız prediktörler olarak saptandı (p< 0.05). Sonuç: Hemodiyaliz hastalarında sol atriyum çapı ve sol ventrikül sistol sonu çapı atriyal fi brilasyonu belirlemede bağımsız prediktörlerdir.

Keywords

• Atriyal fi brilasyon, sol atriyum, sol ventrikül, elektrokardiyografi, ekokardiyografi.

References

1. Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, et al. 2012 focused update of the ESC Guidelines for the man- agement of atrial fi brillation: an update of the 2010 ESC Guide- lines for the management of atrial fi brillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J 2012;33:2719-47. doi: 10.1093/eurheartj/ehs253.
2. Genovesi S, Pogliani D, Faini A, Valsecchi MG, Riva A, Stefani F, et al. Prevalence of atrial fi brillation and associated factors in a population of long-term hemodialysis patients. Am J Kidney Dis 2005;46:897-902.
3. Ansari N, Manis T, Feinfeld DA. Symptomatic atrial arrhythmias in hemodialysis patients. Ren Fail 2001;23:71-6.
4. Pearlman AS, Gardin JM, Martin RP, Parisi AF, Popp RL, Qui- nones MA, et al. Guidelines for optimal physician training in echocardiography. Recommendations of the American Society of Echocardiography Committee for Physician Training in Echocardi- ography. Am J Cardiol 1987;60:158-63.
5. Nedios S, Tang M, Roser M, Solowjowa N, Gerds-Li JH, Fleck E, et al. Characteristic changes of volume and three-dimensional structure of the left atrium in different forms of atrial fi brillation: pre- dictive value after ablative treatment. J Interv Card Electrophysiol 2011;32:87-94. doi: 10.1007/s10840-011-9591-z.
6. Dittrich HC, Pearce LA, Asinger RW, McBride R, Webel R, Zabal- goitia M, et al. Left atrial diameter in non-valvular atrial fi brillation: an echocardiographic study. Stroke Prevention in Atrial Fibrillation Investigators. Am Heart J 1999;137:494-9.
7. Acar G, Akcay A, Dogan E, Isik IO, Sokmen A, Sokmen G, et al. The prevalence and predictors of atrial fi brillation in hemodialysis patients. Turk Kardiyol Dern Ars 2010;38:8-13.
8. Jalife J, Berenfeld O, Mansour M. Mother rotors and fi brillatory conduction: a mechanism of atrial fi brillation. Cardiovasc Res 2002;54:204-16.

9. Stahrenberg R, Edelmann F, Haase B, Lahno R, Seegers J, We- ber-Krüger M, et al. Transthoracic echocardiography to rule out paroxysmal atrial fi brillation as a cause of stroke or transient is- chemic attack. Stroke 2011;42:3643-5. doi: 10.1161/STROKEA- HA.111.632836.
10. Gutierrez C, Blanchard DG. Atrial fi brillation: diagnosis and treat- ment. Am Fam Physician 2011;83:61-8.
11. Sharma ND, McCullough PA, Philbin EF, Weaver WD. Left ven- tricular thrombus and subsequent thromboembolism in patients with severe systolic dysfunction. Chest 2000;117:314-20.