COMPARATIVE-STUDY OF MITRAL ANNULAR CALCIFICATION (MAC) WITH CARDIAC-ARRHYTHMIAS IN DIALYSIS PATIENTS

Cardiac arrhythmias and myocardial malfunction are very frequent in ur emic patients. The pathogenesis and etiology of arrhythmias are very c omplex and still unknown. The sedimentation of calcium salt in myocard ial structures is one of the reasons for emergence of cardiac arrhythm ias (AV conduction defects, ectopic arrhythmias). The appearance of mi tral annular calcification (MAC), as the expression of the speed up pr ocess of atherosclerosis, was noted in younger uremic patients especia lly during hemodialysis. The aim of our research was to compare the in cidence of MAC and cardiac arrhythmias in patients on hemodialysis. Ou r study included 40 patients, 24 male and 16 female, in the age betwee n 20 and 60. Patients were mostly from Zagreb and the Counties of Zagr eb (35%), Karlovac (10%), Slavonski Bred (7,5%), Varazdin (5%) and Poz ega (5%). All 40 patients received 24 hours of Holter monitoring and 2 -D echocardiography of M-mode. The patients were divided in two groups : I MAC+ (N = 23) and II MAC- (N = 17). Frequency of cardiac arrhythmi as in group I was: atrial fibrillation N = 0; conduction defects N = 2 (1%); ventricularectopy Lown grade 3-5 N = 15 (65%); supraventricular ectopy N = 8 (34%), while the frequency of cardiac arrhythmias in gro up II was: atrial fibrillation N = 0; conduction defects N = 0; ventri cular ectopy Lawn grade 3-5 N = 6 (35%), supraventricular ectopy N = 6 (35%). During statistical processing the significant connection of MA C+ and frequency of cardiac arrhythmias was noticed. For both groups w e have not noticed statistical significance in. cardiac arrhythmia com pared to electrolytes, risk factors PTH, and age. The time of hemodial ysis treatment is one af possible factors far incidence of cardiac arr hythmias influenced by MAC. We noticed statistically significant (p < 0.05) difference of rhythm disorders between group I and group II espe cially for the ventricular ectopic activity, the frequency of which wa s higher in. group I than in group II. MAC has probably significant ro le in dialysis patients for the development of cardiac arrhythmias wit hin the framework of series of complicated multifactorial patogenetic mechanisms.