Presence of fragmented QRS may be associated with complex ventricular arrhythmias in patients with essential hypertension.

BACKGROUND: Ventricular arrhythmias (VAs) are frequent in hypertensive patients. Myocardial fibrosis is one of the components of left ventricular hypertrophy secondary to hypertension. Fragmented QRS (fQRS) on electrocardiography (ECG) has been shown to be a marker of myocardial fibrosis. In this study, we aimed to investigate the association between fQRS and complex VAs in patients with essential hypertension. METHODS: Two hundreds consecutive patients who were diagnosed with hypertension were included in the study. The control group consisted of 153 age and sex matched healthy individuals. ECG and transthoracic echocardiography were performed to all patients. fQRS was defined as additional R' wave or notching/splitting of S wave in two contiguous ECG leads. All patients underwent 24-hour Holter monitoring and VAs were classified using Lown's scoring system. Lown class ≥3 VAs were considered as complex VAs. RESULTS: There was no significant difference with respect to age (52 ±â€¯8 vs 52 ±â€¯6 years, p = 0.836) and gender distribution (female: 64% vs 63%, p = 0.907) between the groups. As compared to the healthy individuals, prevalence of fQRS (67% vs 9.2%, p < 0.001) and complex VAs (19% vs 0%, p < 0.001) were significantly higher in patients with hypertension. Furthermore, complex VAs (25.4% vs 6.1%, p = 0.001) were significantly higher in hypertensive patients with fQRS. In multiple logistic regression analysis, left ventricular ejection fraction (OR: 1.11, 95%CI: 1.025 to 1.183; p = 0.006), left ventricular mass index (OR: 1.04, 95%CI: 1.021 to 1.107; p = 0.001) and presence of fQRS (OR: 5.605, 95%CI: 1.427 to 22.019; p = 0.014) were independent predictors for complex VAs. CONCLUSION: The presence of fQRS may be associated with complex VAs in patients with essential hypertension. Therefore, fQRS may be used in risk stratification of complex VAs and sudden cardiac death especially in hypertensive patients with left ventricular hypertrophy.

Presence of fragmented QRS is associated with increased epicardial adipose tissue thickness in hypertensive patients.

BACKGROUND: Epicardial adipose tissue (EAT) is a cardiometabolic risk factor, and its possible relationship with hypertension has been reported previously. Fragmented QRS (fQRS) detected on electrocardiography (ECG) has been demonstrated to be a marker of myocardial fibrosis. In this study, we aimed to investigate the relationship between the thickness of EAT, and presence of fQRS in hypertensive patients. METHODS: Consecutive patients who were diagnosed with hypertension were included in the study. ECG and transthoracic echocardiography (TTE) were performed to all patients. fQRS was defined as additional R' wave or notching/splitting of S wave in two contiguous ECG leads. Thickness of EAT was measured by TTE. RESULTS: This study enrolled 69 hypertensive patients with fQRS on ECG and 45 hypertensive patients without fQRS as the control group. Age (P = .869), and gender distribution (P = .751) were similar in both groups. Left atrial diameter (P = .012), interventricular septal thickness (P < .001), posterior wall thickness (P < .001), left ventricular ejection fraction (P = .009), left ventricular mass (P = .006), left ventricular mass index (P = .014), left ventricular hypertrophy (P = .003), and EAT thickness (P < .001) were found to be significantly increased in patients with fQRS. In multivariate analysis, among these variables only EAT was observed to be an independent predictor of fQRS (odds ratio:3.306 [95% confidence interval, 0.030-0.118], P = .001). CONCLUSION: A significant association exists between the presence of fQRS and EAT thickness in hypertensive patients. The presence of fQRS, just as EAT thickness, may be used as a cardiometabolic risk factor in hypertensive patients.

Investigation of mindin levels in hypertensive patients with left ventricular hypertrophy and QRS fragmentation on electrocardiography.

PURPOSE: Mindin was associated with diabetic nephropathy, podocyte injury, colitis, allergic asthma, liver ischaemia and reperpusion injury and ischaemic brain injury. On the other hand, it was reported as a protective factor against obesity, cardiac hypertrophy, fibrosis and remodelling. Fragmented QRS complexes (fQRS) are markers of altered ventricular depolarisation owing to a prior myocardial scar and fibrosis. In this study, we aimed to investigate mindin levels in hypertensive patients with left ventricular hypertrophy and fQRS on electrocardiography. METHODS: This observational case-control study enrolled 70 (36 female) hypertensive patients with fQRS and 38 (23 female) hypertensive control patients. All patients were evaluated by transthoracic echocardiography. Mindin levels were measured by the enzyme-linked immunosorbent assay (ELISA). Clinical, echocardiographic and laboratory data were compared between patient and control groups. RESULTS: There was no significant difference between patient and control groups in terms of clinical, echocardiographic and routine laboratory parameters. The mindin levels were significantly higher in the patient group than controls (11.3 (7.21-19.31) vs 4.15 (2.86-6.34); p < .001). Multiple logistic regression analyses defined increased mindin levels as an independent predictor for the presence of fQRS (Odds ratio: 1.733; p = .034). Mindin levels >6.74 predicted the presence of fQRS with a sensitifity of 84.3% and specificity of 79.9% on receiver operating characteristic (ROC) curve analysis (The area under the curve:0.889; Confidence Interval: 0.827-0.951; p < .001). CONCLUSION: Mindin expressin is upregulated in hypertensive patients with fQRS complexes. In contrary to previous studies, increased mindin levels may be associated with myocardial fibrosis.

Serum ADMA, endothelial dysfunction, and atherosclerosis in hypervolemic hemodialysis patients

Background/aim: Asymmetric dimethyl arginine (ADMA) is a strong predictor of cardiovascular disease and mortality in patients under hemodialysis treatment. We aimed to investigate the relationship among volume status, endothelial dysfunction, and ADMA in hemodialysis patients. Materials and methods: A total of 120 patients with a history of hemodialysis treatment were included. ADMA and CRP were measured. Echocardiographic evaluation and carotid artery intima-media thickness (CIMT) measurements were performed. Patients were divided into two groups according to clinical evaluation, ultrafiltration rate, vena cava inferior diameter (VCI), and cardiothoracic index (CTI); the two groups were hypervolemic and normovolemic. Results: The hypervolemic group included 61 patients while the normovolemic group included 59 patients. CIMT was higher in the hypervolemic group, but this result was not statistically significant (0.95 mm versus 0.85 mm, P = 0.232). There was a statistically significant difference between the hypervolemic and normovolemic groups in terms of ADMA (P < 0.001) (0.69 ± 0.57 µmol/L and 0.41 ± 0.04 µmol/L, respectively). Positive correlations were observed between serum ADMA, VCI, CTI, CRP, CIMT, and cardiac mass (P < 0.001, P = 0.016, P < 0.001, P = 0.006, P = 0.022, respectively), and negative correlations were observed between ADMA and ejection fraction and albumin (P = 0.024, P = 0.024, respectively). In multiple linear regression analysis, ADMA was independently associated with age, systolic blood pressure, CTI, and volume status. Conclusion: ADMA may be a potential determinant of hypervolemia as well as atherosclerosis in patients under hemodialysis treatment.

Thrombus formation in the interrupted segment of the aorta.

Interrupted aorta is a very rare heart defect in which there is a gap between the ascending and the descending thoracic aorta. It is usually associated with other cardiac anomalies, including ventricular septal defect, ductus arteriosus, and truncus arteriosus. Severe cases present with serious complications such as hypertension, heart failure, or intracranial hemorrhage. Neurological complications are very rare form of presentation and commonly associated with intracranial aneurysms. We have reported a case of interrupted aorta who presented with transient ischemic attack due to thrombus formation in the interrupted segment of the aorta.

Paraoxanase as an indicator of myocardial ischemia and its utility in determining extension of ischemia.

BACKGROUND: The aim of this study was to investigate Paraoxanase 1 (PON-1) activity in patients with ST-elevated and non-ST-elevated acute myocardial infarction (AMI) and to determine its correlation with Gensini scores (GSs). METHODS: A total of 109 patients with AMI and 58 healthy subjects as control group were included in the study. Patients were divided into 2 subgroups as ST-elevated and non-ST-elevated AMI patients (Group I and II, respectively). Controls were named as Group III. PON-1 activity was determined on admission to emergency department for each group. In addition, GSs for patient groups were determined. Then, groups were compared according to their results. RESULTS: PON-1 levels in Group I and II were significantly lower when compared to Group III. Median GSs for Group I and II were 60 and 64, respectively. The cut-off value of PON-1 for diagnosis of AMI was ≤180 U/L, which was identified by receiver characteristics receiver curve analysis. However, we could not determine a significant relationship between serum PON-1 levels and GSs in patients with AMI. CONCLUSION: PON-1 levels measured on admission to emergency department may be used to rule out AMI. PON-1 levels in AMI patients are found to be inefficient in determining extension of ischemia measured by GS.

Angina severity predicts worse sleep quality after coronary artery bypass grafting.

OBJECTIVE: We sought to reveal whether the severity of angina pectoris affects sleep quality after elective coronary artery bypass grafting. MATERIAL AND METHODS: Patients scheduled to undergo isolated coronary artery bypass grafting were divided into two groups, having a recent myocardial infarction (Group 1, n=22, mean age 59.40±7.79 years) or not having a recent myocardial infarction (Group 2, n=30, mean age 59.73±7.72 years). The assessment included the Canadian Cardiovascular Society Angina Score, the visual analogue scale for postoperative pain and the Pittsburgh Sleep Quality Index (PSQI). RESULTS: The two groups were similar in regard to baseline characteristics. Cross-clamp time was significantly higher (p=0.007) and the use of inotropes was significantly more common (p=0.01) in those patients with recent myocardial infarction compared to those without. Mean Canadian Cardiovascular Society scores were also higher in patients with recent myocardial infarction (p=0.02). Total Pittsburgh Sleep Quality Index score was significantly higher in patients with recent myocardial infarction (8.45±3.50 vs. 5.03±2.32, respectively, p<0.001). In multivariate analysis, higher angina score (OR: 3.27, 95% CI, 1.20-8.90, p=0.02) and longer time of intensive care unit stay (OR: 6.15, 95% CI, 1.49-25.35, p=0.01) were found to be independent predictors of poor sleep quality. The Canadian Cardiovascular Society angina score showed a significant positive correlation with poor sleep duration score (<0.001), sleep disturbance score (p=0.02), day dysfunction due to sleepiness score (p=0.001), sleep efficiency score (p=0.003), overall sleep quality score (0.03) and total PSQI score (p=0.004). CONCLUSION: The severity of angina pectoris in the preoperative period is independently associated with worse sleep quality after elective isolated coronary artery bypass surgery.

Treatment outcomes and prognostic factors in patients with driver mutant non-small cell lung cancer and de novo brain metastases.

Central nervous system (CNS) metastases can be seen at a rate of 30% in advanced stages for patients with non-small cell lung cancer (NSCLC). Growing evidence indicates the predictive roles of driver gene mutations in the development of brain metastases (BM) in recent years, meaning that oncogene-driven NSCLC have a high incidence of BM at diagnosis. Today, 3rd generation targeted drugs with high intracranial efficacy, which can cross the blood-brain barrier, have made a positive contribution to survival for these patients with an increased propensity to BM. It is important to update the clinical and pathological factors reflected in the survival with real-life data. A multi-center, retrospective database of 306 patients diagnosed with driver mutant NSCLC and initially presented with BM between between November 2008 and September 2022 were analyzed. The median progression-free survival (mPFS) was 12.25 months (95% CI, 10-14.5). While 254 of the patients received tyrosine kinase inhibitor (TKI), 51 patients received chemotherapy as first line treatment. The median intracranial PFS (iPFS) was 18.5 months (95% CI, 14.8-22.2). The median overall survival (OS) was 29 months (95% CI, 25.2-33.0). It was found that having 3 or less BM and absence of extracranial metastases were significantly associated with better mOS and iPFS. The relationship between the size of BM and survival was found to be non-significant. Among patients with advanced NSCLC with de novo BM carrying a driver mutation, long-term progression-free and overall survival can be achieved with the advent of targeted agents with high CNS efficacy with more conservative and localized radiotherapy modalities.

Pretreatment PLR Is Preferable to NLR and LMR as a Predictor in Locally Advanced and Metastatic Bladder Cancer.

Background/Aim: Advanced bladder cancer (BC) is associated with an inflammatory nature and poor prognosis Inflammatory biomarkers are potential predictors in BC. We conducted a study to assess the prognostic value of the pretreatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in advanced bladder cancer. Patients and Methods: A total of 226-patients with muscle-invasive BC (MIBC) were included. Overall (OS) and progression-free survival were estimated using the Kaplan-Meier method and the log-rank test was used for comparison. Univariate and multivariate Cox proportional hazard models were used to determine NLR, PLR, and LMR association with OS. Results: Our patients' median progression-free survival and OS were 12.18 and 15.54 months, respectively. Receiver operating characteristic analysis revealed cut-off values for our chosen inflammatory markers. The patients with high NLR or PLR had inferior median OS compared to their counterparts with lower ratios for both (NLR: 22.51 vs. 9.84 months, respectively, p≤0.001; PLR: 17.68 vs. 14.08 months, respectively, p=0.08). Meanwhile, patients with low LMR had inferior median OS compared to patients with higher LMR (LMR: 20.14 months vs. 10.55 months, respectively, p<0.001). The multivariate Cox regression analysis identified a high PLR as an independent predictive factor of worse OS (hazard ratio=2.774, 95% confidence interval=1.486-5.178, p=0.001) but not NLR or LMR. Conclusion: PLR, C-reactive protein-to-albumin ratio, and serum LDH levels, but not NLR and LMR, may function as independent predictors in patients with advanced BC prior to systemic treatment.

Lower plasma soluble TWEAK concentration in patients with newly diagnosed hypertension.

PURPOSE: To determine circulating levels of the soluble TNF-like weak inducer of apoptosis (sTWEAK)and its association with demographic and biochemical parameters in a young group of patients with newly diagnosed and never treated hypertension. METHODS: A total of 51 patients (mean age 21.7 ±1.4 years, body mass index (BMI) 24.5 ±1.6 kg/m2) with primary untreated hypertension, and 37 age- and BMI-matched healthy controls (mean age 22.5 ± 1.9 years, BMI 24.7 ± 1.5 kg/m2) were studied. Serums TWEAK and plasma asymmetrical dimethyl arginine (ADMA) levels were measured by EIA. RESULTS: In patients and controls, mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 149.8±5.65/93.4±3.4 mmHg and 124.2±6.4/78.24±5.5 mmHg, respectively. Serum sTWEAK levels were lower in the patient group (882.6±228.9 µmol/L vs. 1060.2±231.7µmol/L, p=0.001), whereas plasma ADMA levels were higher(0.837±0.34µmol/L vs.0.3176±0.25µmol/L, p < 0.001). sTWEAK serum levels correlated with SBP(r=-0.301; p=0.005) and DBP (r=-0.279; p=0.009). Circulating plasma ADMA levels also correlated with SBP (r=0.734; p < 0.001) and DBP (r=0.733; p < 0.001). CONCLUSION: Young patients with yet untreated primary hypertension have lower circulating serum sTWEAK level compared with healthy controls. Further research for possible associations among serum sTWEAK, endothelial dysfunction and other measures of atherosclerosis may be of benefit in order to better understand the pathophysiology of hypertension and to establish more effective treatment options.

Evaluation of Serum microRNA Let-7c and Let-7d as Predictive Biomarkers for Metastatic Pancreatic Cancer.

BACKGROUND: First-line treatments for metastatic pancreatic cancer are chemotherapy regimens consisting of 5-fluorouracil or gemcitabine; however, there are no biomarkers to help determine which patients might benefit from which treatment regimens. We aimed to show that microRNAs let-7c and 7d can be used as independent predictive biomarkers for metastatic pancreatic cancer. METHODS: A total of 55 patients who had first-line chemotherapy with FOLFIRINOX or gemcitabine+capecitabine were included. Patients were divided into groups based on let-7c and let-7d levels and chemotherapy treatment as let-7c-7d high FOLFIRINOX, let7c-7d high gemcitabine+capecitabine, let-7c-7d low FOLFIRINOX, and let-7c-7d low gemcitabine+capecitabine. Blood samples were taken from patients before chemotherapy for microRNA let-7c and 7d analysis. MicroRNA isolation was performed using a miRNeasy Serum/Plasma Kit and identified using spectrophotometric measurements. After isolation, microRNA was converted to cDNA using a microRNA cDNA Synthesis Kit with poly (A) polymerase tailing. The expression of microRNA was examined using quantitative real-time polymerase chain reaction. RESULTS: The overall survival of patients who received FOLFIRINOX treatment with a high let-7c-7d level was statistically significantly longer than those who received gemcitabine+capecitabine with a high let-7c-7d level. In addition, patients with low let-7c expression receiving FOLFIRINOX progressed significantly 2.104 times earlier than patients with high let-7c expression receiving FOLFIRINOX. CONCLUSION: The serum MicroRNA let-7c level was found to be an independent predictive biomarker in the FOLFIRINOX treatment group.

An Evaluation of Aspirin Treatment Preferences ORIGINAL INVESTIGATION of Physicians in Hypertensive Patients in Terms of Current Guidelines: A Subgroup Analysis of the ASSOS Trial in Turkey.

BACKGROUND: The Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study trial has been the largest study ever conducted among patients in Turkey regarding aspirin treatment. In the subgroup analysis of the hypertensive group of the Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study trial, we aimed to evaluate the physicians' adherence to current guidelines regarding their aspirin treatment preferences. METHODS: The Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study trial is a cross-sectional and multicenter study conducted among 5007 consecutive patients aged ≥18 years. The study population consisted of outpatients on aspirin treatment (80-300 mg). The patient data were obtained from 30 different cardiology clinics of 14 cities from all over Turkey. In this subgroup analysis, patients were divided into 2 groups: the hypertensive group (n=3467, 69.3%) and the group without hypertension (n=1540, 30.7%) according to the 2018 European Society of Cardiology/ European Society of Hypertension Guidelines for the Management of Arterial Hypertension. RESULTS: Aspirin use for primary prevention was higher in patients with hypertension compared to patients without hypertension [328 (21.3%); 1046 (30.2%); P < .001]. Treatment with a dose of 150 mg aspirin (n=172, 5%) was mostly preferred by internists for hypertensive patients (n =226, 6.5%); however, a daily dose of 80-100 mg aspirin therapy (n=1457, 94.6%) was mostly prescribed by cardiologists (n=1347, 87.5%) for patients without hypertension. CONCLUSION: Aspirin was found to be used commonly among patients with hypertension for primary prevention despite the current European Society of Cardiology Arterial Hypertension Guideline not recommending aspirin for primary prevention in patients with hypertension.

The Effect of Continuing Chemotherapy after Chemoradiotherapy during the Time to Surgery on Tumor Response and Survival for Local Advanced Rectal Cancer.

Aim: The current standard treatment of locally advanced rectal carcinoma is total mesorectal excision and postoperative adjuvant chemotherapy after neoadjuvant concurrent chemoradiotherapy (NCRT). Many studies have shown that pathological complete response (pCR) is an important prognostic factor for patients receiving NCRT. Many studies have therefore been conducted to increase pCR rates by changing the perioperative treatment strategies. Prolonging the chemotherapy time may be a reasonable way to increase the effectiveness of NCRT, pCR, and survival rates. We investigated whether neoadjuvant consolidation chemotherapy had an effect on tumor response and survival. Methods: The data of 163 patients diagnosed with locally advanced rectal carcinoma were evaluated. The data of 107 patients (Group 1) who were radiologically T3-T4 and/or N+ and received chemotherapy after NCRT until their operations were compared with the data of 56 patients (Group 2) who were operated after NCRT. Results: Group 1 patients had tumor and node downstaging. Their pCR was found significantly higher than in Group 2 (p = 0.005). In Group 1 patients with T3, pCR was significantly higher than for those with T4. The elapsed time between NCRT and surgery was significantly longer in patients with pCR (respectively, p = 0.012 and p = 0.008). Conclusion: Neoadjuvant consolidation chemotherapy after NCRT is a safe approach that can lead to higher pathological complete response rates. The time until surgery with neoadjuvant consolidation chemotherapy may provide the chance to follow the patient without surgery in addition to increasing pCR.

Clinical presentation and course of the novel coronavirus disease 2019 in patients with various types of cancer: A retrospective case-control analysis of an experienced cancer center in Turkey.

OBJECTIVE: Cancers have been reported to worsen the clinical course of coronavirus disease 2019 (COVID-19) infection. We aimed to demonstrate the real-life data on health outcomes in COVID-19-infected cancer patients. MATERIALS AND METHODS: We analyzed the data of 43 COVID-19-infected cancer patients in our COVID-19 clinics between March 25, 2020, and May 9, 2020, retrospectively. RESULTS: We determined that 1051 patients were followed up with COVID-19 infection and 43 (4%) of them were cancer patients. The mean age of the patients was 64.3 ± 12.3 years. Lung cancer is the most common cancer type among the patients (23.2%). Dyspnea (51.2%) was the most common symptom in the first admission. Typical ground-glass consolidation or patchy appearance with peribronchial thickening resembling bronchopneumonia on high-resolution computed tomography (HRCT) was present in 29 (67.4%) patients. COVID-19 was diagnosed in 14 (32.5%) patients based on reverse transcriptase-polymerase chain reaction analysis of nose-throat swab samples without any sign of lung involvement on HRCT. Total mortality of the COVID-19 infection was 46.5% (n = 20). Presence of heart disease (hazard ratio [HR]: 3.5; 95% confidence interval [CI]: 1.29-9.4), previous surgeries to the respiratory system (HR: 6.95; 95% CI: 1.29-27.7), and presence of dyspnea at admission (HR: 4; 95% CI: 1.31-12.3) were statistically significantly associated with death (P = 0.01, 0.02, and 0.01, respectively). CONCLUSION: Our practices supported that cancer patients were more affected by COVID-19 disease than the normal population. However, our findings can not be generalized due to being retrospective and single centered study, Also, we did not compare the findings with noncancer patients with COVID19 disease.

Inappropriate Use of Aspirin in Real-Life Cardiology Practice: Results from the Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study (ASSOS) Study.

BACKGROUND: Indications and appropriateness of aspirin use have not been well investigated in Turkey. AIMS: To investigate the prescription patterns and appropriateness of aspirin in a real-world clinical setting. STUDY DESIGN: Cross-sectional study. METHODS: The Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study (ASSOS) is a cross-sectional and multicenter study that included 5007 consecutive patients aged 18 or over who presented to 30 different cardiology outpatient clinics from 14 cities throughout Turkey. Only patients using aspirin (80-325 mg) were included. The study population was divided into 2 groups regarding the use of aspirin: primary prevention (PP) group and secondary prevention (SP) group. The indication of aspirin use was evaluated following the 2016 European Society of Cardiology (ESC) and the 2016 United States Preventative Services Task Force (USPTF) guidelines in the PP group. RESULTS: A total of 5007 patients (mean age 62.15 ± 11.05, 39% female) were enrolled. The PP group included 1132 (22.6%) patients, and the SP group included 3875 (77.4%) patients. Of the 1132 patients, inappropriate use of aspirin was determined in 100% of the patients according to the ESC guidelines, and 71% of the patients according to the USPTF guidelines. Multivariate logistic regression analysis showed age OR: 0.98 CI (0.97-0.99) P = .037, smoking OR: 0.60 CI (0.44-0.82) P = .001, heart failure OR: 2.11 CI (1.14-3.92) P = .017, hypertension OR: 0.51 CI (0.36-0.74) P < .001, diabetes mellitus OR: 0.34 CI (0.25-0.47) P < .001, oral anticoagulant use OR: 3.01 CI (1.10-8.25) P = .032, and female sex OR: 2.73 CI (1.96-3.80) P < .001 were independent predictors of inappropriate aspirin use in PP patients. CONCLUSION: Although there are considerable differences between the USPTF and the ESC guidelines with respect to recommendations for aspirin use in PP, inappropriate use of aspirin in Turkey is frequent in real-world practice for both guidelines. Besides, heart failure, oral anticoagulant use, and the female sex of the patients were independent predictors of inappropriate use of aspirin.

Echocardiographic predictors of interatrial block in patients with severe chronic kidney disease.

BACKGROUND: Interatrial block (IAB), defined as a conduction delay between the right and left atrium, is manifested on the electrocardiogram as a prolonged P-wave duration. Large number of studies recently have been published regarding the prevalence of IAB and its associations with the risk of atrial fibrillation and ischemic stroke. Cardiovascular diseases are the leading causes of mortality in chronic kidney disease (CKD). In this study, we aimed to investigate echocardiographic predictors of IAB in patients with severe CKD. METHODS: This study enrolled a total of 155 patients [male: 95 (61.3%), mean age: 56.3 ± 12.8 years] with severe CKD (glomerular filtration rate < 30 mL/min). All patients were evaluated by electrocardiography and transthoracic echocardiography. IAB was defined as P wave duration of ≥ 120 ms on electrocardiography. RESULTS: Electrocardiography revealed IAB in 54 patients. The baseline demographic characteristics of the patients were similar in both groups with and without IAB. Left atrial diameter (LAD), left ventricular end-systolic and end-diastolic diameters, interventricular septal thickness, posterior wall thickness, left ventricular mass, left ventricular mass index (LVMI), and the prevalence of left ventricular hypertrophy were found to be significantly increased in patients with IAB. Increased LAD (OR = 1.119; 95% CI 1.019-1.228; p = 0.019) and LVMI (OR = 1.036; 95% CI 1.003-1.070; p = 0.031) were found to be independent predictors of IAB. CONCLUSION: A significant association exists between the presence of IAB and echocardiographic parameters related to left ventricular hypertrophy and left atrial dilatation. Presence of IAB may be an additional and easy diagnostic marker for risk stratification of patients with severe CKD.