The effect of dialysis type on left atrial in patients with uremia by real time three-dimensional echocardiography

LIU Yuan; ZHENG Lili; DAI Hongyan

Abstract：Objective Real Time three-dimensional Echocardiography(RT-3DE)was used to compare the effects of differ-ent dialysis methods on left atrial volume and function in uremia patients from the perspective of volume changes.Methods A total of 81 patients with uremia in our hospital were selected.There were 20 cases in stage 5 chronic kidney disease group,30 cases in peritoneal dialysis group,and 31 cases in hemodialysis group.Conventional echocardiography and RT-3DE were per-formed in different groups to acquire the changes of the left atrial structure and function.Results Interventricular septum thick-ness(IVST),left ventricular end-diastolic diameter(LVEDD),left ventricular mass index(LVMI)and left ventricular ejection fraction(LVEF)showed no significant differences among the three groups(all P<0.05).The prevalence of left ventricular dia-stolic dysfunction(LVDD)and left ventricular hypertrophy(LVH)show no statistical differences among the three groups.There were no significant differences in left atrial volume parameters(LAVmax,LAVmin,LAVp and LAVI)between CKD5 and PD,CKD5 and HD.RT-3DE showed that left atrial maximun volume and left atrial minimum volume in PD group were significantly lower than those in HD group,with statistical differences(P= 0.030,P<0.001).There was no significant difference in volume parameter LAVp between HD group and PD group.The Left atrial volume index in PD group was lower than that in HD group,and the difference was statistically significant(P=0.024).The left atrial ejection fraction of PD group was significantly higher than that of HD group(P<0.001)and also higher than that of CKD5 group,but the difference was not statistically significant.The left atrial active ejection fraction of PD group and CKD5 group was significantly higher than that of HD group,and the difference between the measured results was statistically significant(P<0.05).Conclusions RT-3DE can simply and accurately evalu-ate the structural changes and functional differences of left atrial in patients with uremia treated by different dialysis methods.PD and HD cannot improve left ventricular hypertrophy and diastolic dysfunction,but PD may be slightly better than HD in preserv-ing and maintaining left atrial structure and function.