Relationship of P Terminal Force V1 on Electrocardiogram with Left Atrial Function in Chronic Kidney Failure Patients on Hemodialysis

Kartika Apshanti; Putrika Prastuti Ratna Gharini; Hasanah Mumpuni

doi:10.22146/aci.50216

Relationship of P Terminal Force V1 on Electrocardiogram with Left Atrial Function in Chronic Kidney Failure Patients on Hemodialysis

https://doi.org/10.22146/aci.50216

Kartika Apshanti^(1*), Putrika Prastuti Ratna Gharini⁽²⁾, Hasanah Mumpuni⁽³⁾

(1) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada– Dr. Sardjito Hospital, Yogyakarta
(2) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada– Dr. Sardjito Hospital, Yogyakarta
(3) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada– Dr. Sardjito Hospital, Yogyakarta
(*) Corresponding Author

Abstract

Background: Chronic kidney failure is a worldwide public health problem.Cardiovascular disease is a common complication and the main cause of mortality in this population.Impaired left atrial function is an early marker of cardiovascular involvement and a prognostic factor that correlated with mortality in chronic kidney disease patients. We aim
to investigate the relationship between P terminal force V1 (PTFV1), an ECG parameter, with left atrial function in chronic kidney failure patients on hemodialysis.

Method: This cross sectional study was done in chronic kidney failure patients on hemodialysis in Dr. Sardjito General Hospital Jogjakarta. Electrocardiogram and echocardiography were done after hemodialysis procedure. P terminal force V1 was measured by multiplying amplitude and duration of negative deflection of terminal P wave in V1. Abnormal PTFV1 was defined as PTFV1 value ≥ 40 mm.msec. Left atrial function was measured using left atrial peak global longitudinal strain (LA PGLS).

Results: This study was done in 71 patients with mean age 50 years old. Forty three subjects (61%) were men. Sixty four subjects (90%) had hypertension. Forty four subjects (62%) had abnormal PTFV1 on ECG. Mean LA PGLS was 24.89 ± 8.23%. No significant correlation was found between PTFV1 value with LA PGLS (r= -0.178; p=0.138). By multivariate analysis, left ventricular ejection fraction, left atrial diameter and hemodialysis duration (in months) were variables that independently correlated with LA PGLS. In subanalysis, amplitude of negative deflection of terminal P wave in V1 was significantly correlated with LA PGLS(r= -0.257, p= 0.031).

Conclusions: This study reveals no correlation between P terminal force V1 and left atrial function in chronic kidney failure patients on routine hemodialysis. There is significant correlation between amplitude of negative deflection of terminal P wave in V1 with LA PGLS.