Predictive value of atrial electromechanical delay on long-term cardiovascular outcomes in hemodialysis patients

Kultigin Turkmen, Levent Demirtas, Ergun Topal, Abduzhappar Gaipov, Ismail Kocyigit, Ozcan Orscelik, Ibrahim Guney, Selim Kilic, Mahmut Ilker Yilmaz

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4 Citations (Scopus)

Abstract

Background: Atrial electromechanical delay (AEMD) times were considered independent predictors of cardiovascular morbidity among the general population. We aimed at evaluating AEMD times and other risk factors associated with 2-year combined cardiovascular (CV) events in HD patients. Material and Methods: Sixty hemodialysis (HD) and 44 healthy individuals were enrolled in this prospective study. Echocardiography was performed before the mid-week dialysis session for HD patients. Data were expressed as mean ± SD. Spearman test was used to assess linear associations. Survival was examined with the Kaplan-Meier method. Multivariate Cox regression analysis was used to determine the predictors of combined CV events in this cohort. Results: At the beginning of the study, left intra-atrial-AEMD times were significantly longer in HD patients compared to the left intra-atrial-AEMD times in healthy individuals. After 24 months, 41 patients were still on HD treatment and 19 (31.6%) had died. Serum triglyceride, total cholesterol and albumin were found to be higher and C-reactive protein (CRP) levels, left intra-atrial EMD time (LIAT) and interatrial EMD times were found to be lower in survived HD patients. With the cut-off median values of 3.5 g/dl for albumin, 0.87 mg/dl for CRP, 157 mg/dl for total cholesterol and 151 mg/ dl for triglyceride, the Kaplan-Meier curves demonstrated significant differences in terms of all-cause mortality. We also demonstrated the Kaplan-Meier survival curves of HD patients according to tertile values of LIAT. Cox regression analysis revealed that increased CRP and higher LIAT were found to be independent predictors of combined CV events. Conclusions: Increased LIAT and inflammation were found to be closely associated with 2 years combined CV events and all-cause mortality in HD patients.

Original languageEnglish
Pages (from-to)239-249
Number of pages11
JournalAmerican Journal of Nephrology
Volume42
Issue number3
DOIs
Publication statusPublished - Jan 1 2015

Keywords

  • Combined CV events
  • Hemodialysis
  • Left intra-atrial electromechanical delay time
  • Malnutrition

ASJC Scopus subject areas

  • Nephrology

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    Turkmen, K., Demirtas, L., Topal, E., Gaipov, A., Kocyigit, I., Orscelik, O., Guney, I., Kilic, S., & Yilmaz, M. I. (2015). Predictive value of atrial electromechanical delay on long-term cardiovascular outcomes in hemodialysis patients. American Journal of Nephrology, 42(3), 239-249. https://doi.org/10.1159/000441099