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

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Abstract
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.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/Vmax. 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.Mean fluid removal was 1,875 +/- 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.The results of this study suggest that left atrial mechanical functions improve after haemodialysis in patients with chronic renal failure.

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