Abstract: TH-PO0523
Longitudinal Changes in Cardiac Echocardiographic Parameters in Patients on Hemodialysis with and Without Atrial Fibrillation
Session Information
- Dialysis: Novel Therapeutics and Medication Management
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Travlos, Christoforos K., Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Baroz, Frederic, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Chirgwin-Dasgupta, Adario, McGill University Health Centre, Montreal, Quebec, Canada
- Kwok, Winston Tse-Hou, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
- Sniderman, Allan, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Alam, Ahsan, McGill University Health Centre, Montreal, Quebec, Canada
- Mavrakanas, Thomas A., Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
Background
Atrial fibrillation (AF) is common in hemodialysis (HD) patients but its impact on cardiac structure in this population remains unclear. We investigated the association between incident or prevalent AF and echocardiographic changes in an incident HD cohort.
Methods
We conducted a retrospective, cohort study of patients initiating HD between 2017-2022. Eligible patients had ≥2 transthoracic echocardiograms (TTE): one before and at least one after HD start. AF status was classified as: No AF, Prevalent AF (onset before or ≤90 days from HD start), or Incident AF (>90 days post-HD start). Associations between AF status and TTE trajectories over time were assessed with linear mixed models. Inverse probability weights for developing AF were applied.
Results
We included 109 patients (44 with AF). Baseline characteristics were balanced after weighting. At HD initiation, left atrial volume index (LAVI) was significantly higher in patients with prevalent AF versus those without AF (p<0.01), with both groups showing similar decline over time. Patients who developed incident AF had similar baseline LAVI to the No AF group (p=0.55) but experienced a significant increase over time (Figure 1).
Left ventricular end-diastolic volume index (LVEDVI) was comparable across groups at baseline. LVEDVI declined significantly in the No AF group (p<0.01) and in the Prevalent AF group but remained unchanged in the Incident AF group, indicating a distinct remodeling pattern (Figure 1). Additional TTE parameters are shown in Figure 2.
Conclusion
While prevalent AF was associated with higher baseline atrial volume, only incident AF showed progressive atrial enlargement and impaired ventricular unloading, suggesting a maladaptive, dialysis-intolerant phenotype warranting closer surveillance.
Fig. 1
Fig. 2
Funding
- Government Support – Non-U.S.