Aim. Supraventricular arrhythmias (SVA) are associated with high morbidity and mortality. However, little attention is paid to this condition in patients undergoing hemodialysis. The aim of this study was to analyze the long-term relationship of intradialytic SVA, including asymptomatic arrhythmias, with adverse events in a cohort of patients undergoing hemodialysis.Material and methods. An observational prospective study was conducted in a group of patients on hemodialysis with a 10-year follow-up. The study involved 77 patients (42 men and 35 women; mean age 58±15 years) with sinus rhythm, then they were monitored for ECG for six consecutive hemodialysis sessions during recruitment.Results. Arterial hypertension was present in 68.8% of patients, diabetes mellitus in 29.9% of patients. SVA were reported in 38 patients (49.3%); they all had a short-term, asymptomatic character and were terminated independently. Age (hazard ratio [HR] 1.04 per year; 95% confidence interval [CI] 1.00-1.08) and an increase of the atrium (HR 4.29; 95%CI 1.30-14.09) were associated with supraventricular arrhythmia in multidimensional analysis. During an average follow-up of 40 months, 57 patients died, and cardiovascular diseases were the main cause of death (52.6%). Variables associated with all-cause mortality in the Cox model were age (HR 1.04 per year; 95%CI 1.00-1.08), C-reactive protein (HR 1.04 per 1 mg/l; 95%CI 1.00-1.08) and supraventricular arrhythmias (HR 3.21; 95%CI 1.29-7.96). Patients with supraventricular arrhythmias also had a higher risk of nonfatal cardiovascular events (HR 4.32; 95%CI 2.11-8.83) and symptomatic atrial fibrillation during observation (HR 17.19; 95%CI 2.03-145.15).Conclusions. Strong relationships have been established between the presence of supraventricular arrhythmias recorded during ECG during dialysis and symptomatic AF developing in the future. Patients with supraventricular arrhythmias had a larger right atrium. Age and supraventricular arrhythmias are the main variables associated with mortality in dialysis patients.

Aim. To assess the impact of renal risk factors (RFs) and local vascular factors on cardiovascular survival in patients with disturbed intracoronary hemodynamics after myocardial revascularization. Material and methods. In total, 99 patients with indications for myocardial revascularization (mean age 56,5±0,8 years) were examined. All participants were divided into two groups: Group I — with 3 or less RFs, and Group II — with 4 or more RFs. The renal RFs included microalbuminuria (MAU) and glomerular filtration rate (GFR). The area of atherosclerotic plaque (SAP) and the rate of its intra-luminal growth (VAP) were calculated. Results. Group II demonstrated higher MAU levels than Group I: 171,2±23,9 vs. 112,9±11,99, respectively (р=0,03). In addition, SAP values were higher in Group II (8,02±0,22 vs. 6,94±0,29 in Group I; р=0,004), as well as VAP values (6,62±1,26 vs. 1,44±0,18 in Group I; р<0,001). Conclusion. Increased number of traditional RFs could be associated with increased MAU, hemodynamically significant coronary stenosis, and higher rate of atherosclerotic plaque growth.

Relevance. Supraventricular arrhythmias are frequent comorbid conditions in patients with end-stage renal failure undergoing dialysis. The prevalence of atrial fibrillation (AF) in this group of patients is higher than in the general population and is associated with increased mortality. Aim. To analyze the effect of a dialysis session on echocardiographic parameters and to assess their relationship with the occurrence of supraventricular arrhythmias and AF during hemodialysis. Material and methods. The study included 78 patients on hemodialysis. All patients underwent Holter electrocardiography monitoring, taking into account the heart rate before and after dialysis, the number and duration of AF episodes associated with the dialysis session. Using echocardiography, which was performed before and after the dialysis procedure, all patients were also evaluated for the presence of left ventricular (LV) hypertrophy, impaired systolic and diastolic function, as well as LV myocardial mass, sizes of the left atrium, its volume, volume of the right atrium and LV ejection fraction. Results. An analysis of the differences in echocardiographic parameters before and after dialysis showed a significantly larger volume of the left atrium, the volume of the right atrium, the width of the inferior vena cava, and the parameter P(early transmitral velocity) before dialysis compared with the state after dialysis. Also, AF paroxysms were recorded much more frequently after dialysis. The volume of the left atrium 32 mm and the right atrium 30 mm (limit values) were observed much more often in patients before dialysis. A relationship was found between an increased number of paroxysms of atrial fibrillation and a decrease in the volume of the right atrium 5 mm and the left atrium 7 mm after dialysis. No correlation was found between the mass of the LV and the volume of the left atrium. Conclusions. 1. The age and duration of dialysis therapy in hemodialysis patients are associated with an increased risk of atrial fibrillation. 2. A decrease in the volumes of the right and left atriums after the hemodialysis procedure has a positive correlation with paroxysmal AF. 3. The hemodialysis procedure leads to a decrease in the volumes of the right and left atriums, as well as the width of the inferior vena cava and a decrease in the speed of movement of the mitral valve in early diastole. 4. No relationship was found between the volume of the left atrium and the mass of the LV myocardium in patients on hemodialysis.

No abstract

No abstract