Department of Cardiology, Faculty of Medicine, Hitit University, Buharaevler Mah. Buhara 25. Sok. No:1/A Daire:22, Çorum, Turkey.
Department of Nephrology, Faculty of Medicine, Hitit University, Çorum, Turkey.
Int Urol Nephrol. 2020 May;52(5):933-941. doi: 10.1007/s11255-020-02430-0. Epub 2020 Mar 10.
Interatrial block (IAB), defined as a conduction delay between the right and left atrium, is manifested on the electrocardiogram as a prolonged P-wave duration. Large number of studies recently have been published regarding the prevalence of IAB and its associations with the risk of atrial fibrillation and ischemic stroke. Cardiovascular diseases are the leading causes of mortality in chronic kidney disease (CKD). In this study, we aimed to investigate echocardiographic predictors of IAB in patients with severe CKD.
This study enrolled a total of 155 patients [male: 95 (61.3%), mean age: 56.3 ± 12.8 years] with severe CKD (glomerular filtration rate < 30 mL/min). All patients were evaluated by electrocardiography and transthoracic echocardiography. IAB was defined as P wave duration of ≥ 120 ms on electrocardiography.
Electrocardiography revealed IAB in 54 patients. The baseline demographic characteristics of the patients were similar in both groups with and without IAB. Left atrial diameter (LAD), left ventricular end-systolic and end-diastolic diameters, interventricular septal thickness, posterior wall thickness, left ventricular mass, left ventricular mass index (LVMI), and the prevalence of left ventricular hypertrophy were found to be significantly increased in patients with IAB. Increased LAD (OR = 1.119; 95% CI 1.019-1.228; p = 0.019) and LVMI (OR = 1.036; 95% CI 1.003-1.070; p = 0.031) were found to be independent predictors of IAB.
A significant association exists between the presence of IAB and echocardiographic parameters related to left ventricular hypertrophy and left atrial dilatation. Presence of IAB may be an additional and easy diagnostic marker for risk stratification of patients with severe CKD.
房间隔阻滞（IAB）定义为左右心房之间的传导延迟，在心电图上表现为 P 波持续时间延长。最近有大量研究报道了 IAB 的患病率及其与心房颤动和缺血性卒中风险的相关性。心血管疾病是慢性肾脏病（CKD）患者死亡的主要原因。在这项研究中，我们旨在探讨严重 CKD 患者中 IAB 的超声心动图预测因素。
这项研究共纳入了 155 名患者[男性：95 名（61.3%），平均年龄：56.3±12.8 岁]，患有严重 CKD（肾小球滤过率<30mL/min）。所有患者均接受心电图和经胸超声心动图检查。IAB 定义为心电图上 P 波持续时间≥120ms。
心电图显示 54 名患者存在 IAB。有和无 IAB 的患者在基线人口统计学特征方面无显著差异。左心房直径（LAD）、左心室收缩末期和舒张末期直径、室间隔厚度、后壁厚度、左心室质量、左心室质量指数（LVMI）和左心室肥厚的患病率在 IAB 患者中显著增加。增加的 LAD（OR=1.119；95%CI 1.019-1.228；p=0.019）和 LVMI（OR=1.036；95%CI 1.003-1.070；p=0.031）被发现是 IAB 的独立预测因素。
IAB 的存在与与左心室肥厚和左心房扩张相关的超声心动图参数之间存在显著相关性。存在 IAB 可能是严重 CKD 患者风险分层的另一个额外且易于诊断的标志物。
