scholarly journals AB0719 CLINICAL FEATURES OF PATIENTS WITH ANKYLOSING SPONDYLITIS AND SECONDARY AA-AMYLOIDOSIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1654.2-1655
Author(s):  
D. Rumiantceva ◽  
E. Agafonova ◽  
S. Krasnenko ◽  
M. Podryadnova ◽  
A. Starkova ◽  
...  

Background:Secondary AA-amyloidosis is one of the most serious complications of ankylosing spondylitis (AS). Better knowledge of specific to secondary AA-amyloidosis clinical features is important for improving further management of these patients.Objectives:To conduct a comparative analysis of AS patients with and without secondary AA-amyloidosis.Methods:The study included 220 AS patients (according to modified New York criteria) without amyloidosis - Group 1, and 9 AS patients with histologically confirmed secondary AA-amyloidosis – Group 2.Results:Table 1 presents the comparative characteristics of Group 1 and Group 2 patients. Both groups were comparable in terms of patients’ age, rates of HLA B27 positivity, presence of enthesitis, uveitis, inflammatory bowel diseases (IBD), and psoriasis on assessment. Group 2 patients tended to be younger at AS onset, while shorter disease duration and fewer male patients were established for Group 1. Group 2 had higher rates of extra-spinal AS manifestations, such as arthritis and coxitis. It should be noted that all AS patients with secondary AA-amyloidosis were males, with clinically manifest arthritis, involving hip joints, and AS onset in the childhood in 8 out of 9 cases.Table 1.Comparative characteristics of Group 1 and Group 2 AS patients.Group 1 (n=220)Group 2 (n=9)рMean age, M±α, y.35,1±9,540,1±8,6>0.05Mean age at the onset, M±α, y.29,9±9,613,4±7,5<0.05Mean disease duration, M±α, y.6,9±5,626,3±6,5<0.05Men, n (%)162 (73,6%)9 (100%)<0.05HLA B27, n (%)202 (91,8%)9 (100%)>0.05Arthritis, n (%)182 (82,7%)9 (100%)<0.05Coxitis, n (%)119 (54,0%)9 (100%)<0.05Enthesitis, n (%)105 (47,7%)7 (78%)>0.05Uveitis, n (%)52 (23,6%)4 (44,4%)>0.05IBD, n (%)5 (2,2%)0>0.05Psoriasis, n (%)24 (10,9%)0>0.05Conclusion:Patients with AS and secondary AA amyloidosis are predominantly of male gender, who usually get sick in childhood, have 100% HLA-B27 positivity, peripheral arthritis, and coxitis.Disclosure of Interests:None declared

2020 ◽  
Vol 14 (3) ◽  
pp. 45-49
Author(s):  
D. G. Rumyantseva ◽  
E. M. Agafonova ◽  
S. O. Krasnenko ◽  
A. S. Starkova ◽  
M. M. Urumova ◽  
...  

Renal AA amyloidosis is the most severe type of renal pathology in patients with ankylosing spondylitis (AS). The characteristic symptoms of AA amyloidosis in rheumatic diseases do not often occur for years, making it difficult to diagnose it early and to start adequate therapy.Objective: to identify the clinical features of AS complicated by secondary AA amyloidosis.Patients and methods. The investigation enrolled 9 patients with AS (according to the 1984 modified New York criteria) and histologically confirmed secondary AA amyloidosis (Group 1). A comparison group included 216 AS patients without amyloidosis (Group 2).Results and discussion. In Group 1 patients, the age at the onset of AS was significantly less and the disease duration was 4 times longer than those in Group 2. All the patients with AA amyloidosis had enthesitis and arthritis, including those of the hip joints. The scores of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP), and the acute phase inflammation index CRP were higher in Group 1 than in Group 2.Conclusion. The clinical feature of AS complicated by secondary AA-amyloidosis is the long duration of the disease and the high frequency of juvenile onset, non-axial manifestations (arthritis, coxitis and enteritis), as well as the high activity of systemic inflammation.


2021 ◽  
Vol 59 (5) ◽  
pp. 563-570
Author(s):  
E. E. Gubar ◽  
Y. L. Korsakova ◽  
E. Yu. Loginova ◽  
T. V. Korotaeva ◽  
E. A. Vasilenko ◽  
...  

Objective of the study – to compare, in real clinical practice, according to the data of the Russian Psoriatic Arthritis Registry, characteristics of two groups of psoriatic arthritis (PsA) patients: with and without nail psoriasis.Material and methods. 588 PsA patients (277 males and 311 females) with PsA according to CASPAR criteria were included in the Russian Psoriatic Arthritis Registry. Patients’ age was 48.6±0.5 years, disease duration – 7.0±0.3 years. Patients underwent standard clinical examination of PsA activity. Disease activity measures evaluated in this study included DAPSA (Disease Activity in Psoriatic Arthritis), BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and ASDAS-СRP (Ankylosing Spondylitis Disease Activity Score). Enthesitis was measured using LEI (Leeds Enthesitis Index) index. Dactylitis was detected, the number of digits with acute dactylitis was defined. Skin lesion severity was evaluated in terms of BSA (Body Surface Area) affected, and PASI (Psoriasis Area Severity Index); PASI was calculated in case BSA > 3%. The criteria of minimal disease activity (MDA) had been used to assess the treatment efficiency. MDA was achieved if a patient met ≥5 of the 7 following categories: tender joint count (TJC) ≤1, swollen joint count (SJC) ≤1, PASI≤1 or BSA≤3%, patient pain VAS ≤15, patient global activity (PGA) VAS ≤20, Health Assessment Questionnaire Disability Index (HAQ) ≤0.5, and tender entheseal points ≤1. Patients were split into two groups: those with nail psoriasis (group 1), and those without nail psoriasis (group 2).Results. 312 (53.1%) patients had nail psoriasis and 276 (46.9%) did not. Patients’ age in group 1 was 45.7±11.9 years, in group 2 – 48.8±13.2 years (р>0.05). PsA duration in groups 1 and 2 did not differ, it was 7.1±6.6 and 7.0±6.2 years respectively (р>0.05). Higher proportions of patients with nail psoriasis were male, disabled from working and chronic smokers compared to patients without nail psoriasis: 51.9% vs 44.1% (р=0.013), 37.20% vs 26.40% (р<0.01) and 18.9% vs 8.7% (р<0.01) respectively. Patients with nail psoriasis had more severe erosive peripheral arthritis compared to patients without nail psoriasis. Median TJC was 8 [4–15] vs 5 [2–12] (р=0.002), SJC – 5 [1–9] vs 2 [0–7] (р=0.003), and erosive radiographic arthritis of feet was found in 45.0% vs 31.2% of patients (р=0.003) respectively. Group 1 patients had higher disease activity measured by DAPSA – 25 [15–39] vs 20 [12–33] (p=0.001) and ASDAS-CRP – 3.1 [2.2–4.0] vs 2.8 [1.8–3.5] (р=0.004), compared to group 2 patients. Patients with nail psoriasis had higher frequency of heel enthesitis and dactylitis; axial disease was diagnosed more often among them, compared to patients without nail psoriasis. Heel enthesitis was detected in 53 (17.0%) vs 28 (10.1%; р=0.016), dactylitis – in 76 (24.4%) vs 46 (16.7%; р=0.022), spondylitis – in 109 (35.0%) vs 73 (26.4%; р=0.025) patients respectively. Patients in group 1 had worse skin psoriasis than in group 2. Patients with nail psoriasis significantly more often had moderate and severe skin psoriasis according to BSA, compared to patients without nail psoriasis (39.9% vs 26.1% and 14.8 vs 1.1% respectively; р<0.01 for both comparisons); group 2 patients significantly more often had limited skin psoriasis compared to group 1 patients – in 72.8% vs 45.3% of cases respectively (р<0.01). Median PASI index in groups 1 and 2 was 6 [2–14] vs 3 [1–6] respectively (р<0.01). Group 1 patients gave worse assessment of their disease than group 2 patients; median PGA was 50 [40–70] mm vs 50 [30–65] mm VAS respectively (р=0.044). Less patients with nail psoriasis compared to patients without nail psoriasis had achieved MDA throughout the whole study. At the first visit MDA was detected in 3% vs 9% (р=0.006) of patients, at the second – in 12% vs 27% (р<0.001), at the third – in 14% vs 28% (р=0.011), at the fourth – in 17% vs 38% (р<0.001) and at the fifth in 27% vs 52% (р=0.004) of patients respectively. Patients with and without nail psoriasis were given equivalent therapy with diseasemodifying antirheumatic drugs (DMARDs) and biological agents (bDMARDs). DMARDs were given to 78.2% and 80.1% of patients respectively (р>0.05), it was mostly methotrexate (MTX); MTX was used in 66.0% and 64.1% of cases respectively (р>0.05). bDMARDs were prescribed to 22.1% and 28.3% (р>0.05) of patients, including tumour necrosis factor (TNF) inhibitors – in 67% and 63% of cases, interleukin (IL) inhibitors – in 33% and 37% of cases (р>0.05 for both comparisons). Taking into account the similar disease duration and equivalent therapy in both groups, it could be concluded that patients with nail psoriasis achieved MDA less frequently due to greater disease severity.Conclusion. Nail involvement is identified in more than half (53%) of PsA patients of the Russian Psoriatic Arthritis Registry. Nail psoriasis is associated with significantly worse disease status as measured by severe peripheral arthritis, enthesitis, dactylitis, spondylitis and skin lesions; higher frequency of erosive arthritis was detected in this category of patients. Patients with nail psoriasis had achieved MDA less frequently compared to patients without nail psoriasis. Nail involvement is associated with worse response to therapy and patients’ disability. These data emphasize the importance of accurate diagnostics of nail psoriasis and optimization of treatment approach, including “targeted” therapy.


2017 ◽  
Vol 11 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Gulsen Ozen ◽  
Rabia Deniz ◽  
Fatih Eren ◽  
Can Erzik ◽  
Ali Ugur Unal ◽  
...  

Background: Radiographic severity of ankylosing spondylitis (AS) shows such great variance that some patients never develop syndesmophytes throughout the entire disease span, whereas some develop bamboo spine relatively early. Objective: To study the association between ERAP1, IL23R and PTGER4 single nucleotide polymorphisms (SNPs) and radiographic severity in AS patients. Methods: rs27044 and rs30187 (ERAP1), rs11209032 (IL23R) and rs10440635 (PTGER4) SNPs were genotyped in 235 AS patients fulfilling the modified New York criteria. Patients were classified as mild- and severe-AS according to modified Stoke AS spinal score (mSASSS). Mild-AS is defined as having mSASSS of “0” following at least 10 years of disease duration. Severe-AS is defined as having mSASSS of >20 (patients with mild vertebral changes (i.e. squaring or erosions) were omitted for clear stratification) regardless of disease duration. Results: The genotype distributions and allele frequencies of ERAP1 rs27044 and rs30187, IL23R rs11209032 and PTGER4 rs10440635 SNPs were similar in mild- (n=171, mSASSS=0, 55.6% HLA-B27 positive) and severe-AS patients (n=64, mSASSS=48.5±17.8, 73.4% HLA-B27 positive). After adjustment for clinical differences between groups (gender, disease duration, HLA-B27 and smoking status) by logistic regression analysis, none of the alleles in the investigated SNPs were found to be associated with radiographic severity of AS. Conclusion: In radiographically well-categorized AS patients, ERAP1 rs27044 and rs30187, IL23R rs11209032 and PTGER4 rs10440635 SNPs are not found to be associated with radiographic severity of AS.


2013 ◽  
Vol 16 (3) ◽  
pp. 13-16
Author(s):  
T A Raskina ◽  
O A Pirogova

Introduction. There is evidence that patients with ankylosing spondylitis (AS) in the early stages of the disease have a significantly decreased bone mass. However, the prevalence of osteoporosis, and the mechanism of its development in the AS are poorly understood. The appearance of inhibitors of tumor necrosis factor alpha (TNF-α) significantly improved the prognosis and quality of life of patients with AS. The largest clinical experience has been gained in relation to infliximab (INF). Purpose. To assess the impact of IFN therapy on BMD of the femoral neck in patients with AS. Materials and Methods. We observed 65 male patients with a diagnosis of AS (according to the modified New York criteria 1984). In a deployed or late stage of the disease, with a high degree of activity — BASDAI > 4.0. All patients were divided into 2 groups: group 1 (n=25) — patients receiving combination therapy NSAIDs and IFN, group 2 (n=40) — patients with monotherapy at standard doses of NSAIDs (diclofenac 150 mg/ day, 200 mg of nimesulide/day meloxicam, 15 mg/day). IFN was administered a dose of 5 mg/kg of patient body weight: 1st day after 2 weeks and 6 weeks after the first injection, and after every 8 weeks. Follow-up for BMD was performed at 0 and 24 months. Results. We saw the BMD reduction at femoral neck in all patients with AS. During therapy with IFN BMD parameters showed a trend toward stabilization, which is probably due to a decrease in activity of the disease.


2015 ◽  
Vol 9 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Maria L.E Andersson ◽  
Kristina Forslind ◽  
Ingiäld Hafström

The objective of the study was to compare disease characteristics over the first 5 years of disease in patients with RA, with disease onset in 1990s and 2000s, respectively. Methods : All 2235 patients with early RA (disease duration ≤12 months) were recruited from the BARFOT prospective observational study. These patients were divided into group 1 included 1992 to 1999 (N=1084, 66% women) and group 2 included 2000 to 2006 (N=1151, 69% women). Disease Activity Score (DAS28), VAS pain and Health Assessment Questionnaire (HAQ) were assessed during 5 years. Remission was defined as DAS28 <2.6. Results : At inclusion, both women and men in group 2 had higher mean DAS28 (SD) than group 1, 5.42 (1.22) vs 5.26 (1.19), p=0.004 and 5.28 (1.22) vs 5.00 (1.27), p=0.004, respectively, mainly dependant on pain and not on inflammatory related measures. Over time DAS28 decreased and was in both genders, from 6 months to the 5-year follow-up, significantly lower in group 2. At 5-year, both women and men in group 2 had higher rate of remission than women and men in group 1. However, despite reduction of VAS pain and HAQ there were no differences in pain and HAQ between groups at any time point. Conclusion : Patients included in the 2000s achieved higher frequency of remission at the 5 year follow-up compared with those included in the 1990s, suggested to reflect the more active medical treatment. Interestingly, however, improvement in pain and HAQ did not differ between the two patient cohorts.


2021 ◽  
Vol 19 (4) ◽  
Author(s):  
V.K. Tashchuk ◽  
R.A. Nesterovska ◽  
V.O. Kalarash

Purpose – to investigate the distribution of hematological indices in patients withcardiac insufficiency.Material and methods. Data of 26 case histories with diagnosis of IHD have beenanalyzed. Patients with stable angina pectoris of II-III functional class (FC), Diffusecardiosclerosis, complicated in 17 patients with syndromic manifestations of HF II-IIIFC according to New York Heart Association (NYHA), made up group 1, and 9 patientswithout CH -group 2. Of the group 1 surveyed, there were 8 men and 9 women. Ratioindex of leucocytes and erythrocyte sedimentation rate (ESR): L/ESR=L×ESR/100;Neutrophil-lymphocyte ratio index (N/Li); Lymphocyte to monocyte ratio index (Li / Mo);Lymphocyte to eosinophil index (Li/ E) was used among hematological markers.Results. Analyzing the haemogram data, it was found that group 1 patients, unlike group2 patients, had a significantly higher overall white blood cell count (7,96±1,73) × 109and (4,22 ± 0,24) × 109; p<0,05 due to the number of neutrophils (69,41 ± 6,21) % ascompared to group 2 (51,78±1,79)%; p<0,05 as well as a lower level of lymphocyteswas defined in group 1 (22,06±4,07)% versus group 2 (38,55±1,01)%; p<0,05. In genderstudies, men show elevated levels of eosinophils (4,12±0,83)%, as opposed to women(1,56±0,73) %; p<0,05 and lower level of lymphocytes (18,38±1,69)% versus (25,33±2,24)%; p<0,05 and women had a high level of total white blood cells (9,36±0,66) ×109 thanmen (6,36±0,99)×109; p<0,05, in particular lymphocytes. Analysis of hematologicalindices showed that there was a statistically significant difference in determining theN / Li index, which was increased in group 1 patients (3,28±0,78) у.о versus group 2(1,34±0,05) у.о, p<0,05.Conclusion. In gender comparisons, there is an increase in lymphocytes among womencompared to men, so we can assume that women are less susceptible to systemicinflammation. The increase in the N/Li index ratio is due to severe cardiovascularconsequences among patients with coronary heart disease complicated by heart failure.


2021 ◽  
Vol 7 (3) ◽  
pp. 24-27
Author(s):  
S. Tokareva ◽  
R. Kupeev ◽  
Aleksandr Hadarcev ◽  
Sof'ya Belyaeva

The purpose of the work. To show the expediency of using a complex DPN therapy with thio-gammoy-600 in combination with TPP, B12-ankerman and febuxostat. Materials and research methods. The study involved 28 male patients suffering from DM2 aged 56-77 years, with an av-erage age of 64.6±0.7 years. The initial values of average fasting blood glucose were 7.8 ± 1.52 mmol/l, glycosylated hemoglobin 7.4 ± 0.13%. Two groups were identified: group 1 (main) – 14 people and group 2 (control) - 16 people. In group 2, basic DPN therapy was used (thiogamma 600 mg/day for 4 months). For the first 14 days, the drug was administered intravenously, and then administered orally. In group 1, in addition to basic DPN therapy, B12-ankerman and febuxostat (adenuric) – 80 mg/day were received. TPP was carried out on a portable device TPP-03 for 15 minutes daily. This treatment regimen was used for 4 months. The assessment of the quality of life (QL) was carried out using the MOS SF-36 questionnaire. Results and their discussion. Four months after the start of therapy, more pronounced changes were observed in patients of the first group. The total score of the NSS scale in this group increased by 28.9%, and in group 2 - by 18.8%. The positive effect of therapy with adenuric and TES on the course of DPN shows that the use of this treatment will naturally lead to an improve-ment in the quality of life of patients, the dynamics of which was studied according to the results of the SF-36 questionnaire.


Author(s):  
Н.П. Александрова ◽  
В.И. Карандашов ◽  
Д.А. Кудлай

Введение. Нарушение текучести крови, обусловленное повышением ее вязкости и снижением эластичности эритроцитов, может привести к столь значительным расстройствам центральной гемодинамики и микроциркуляции, что возникает дисфункция органов. Цель исследования: изучение доминирующих специфических механизмов, вызывающих нарушение деформируемости эритроцитов при различных заболеваниях. Материалы и методы. Обследован 121 пациент: с геморрагическим панкреонекрозом (n = 16) без острой сопутствующей сердечно-сосудистой патологии (группа 1); с тромбоэмболией магистральных артерий нижних конечностей (n = 37) с локализацией в подвздошной, бедренной и подколенной артериях, со сроком заболевания от 2 до 3 сут (группа 2); с острым тромбозом магистральных артерий нижних конечностей (n = 32) с ишемией II степени и длительностью заболевания от нескольких недель до нескольких месяцев (группа 3); с острым венозным тромбозом (n = 36), срок заболевания варьировал от 24 ч до 30 сут (группа 4). Для контроля изучены показатели 26 практически здоровых лиц (группа 5). Проведено исследование деформируемости эритроцитов методом фильтруемости, изучали распределение эритроцитов по диаметру, определяли показатель гематокрита и механическую резистентность эритроцитов, исследование белкового состава плазмы проводили спектрофотометрическим способом, измеряли содержание сиаловой кислоты в плазме и в эритроцитах. Результаты. Самые тяжелые нарушения морфологических и физико-химических свойств эритроцитов выявлены у больных геморрагическим панкреонекрозом (группа 1): скорость фильтрации эритроцитов была в 1,8 раза меньше, чем у здоровых людей; диаметр эритроцитов в 1,2 раза, а уровень гематокрита на 9% превышали норму; механическая резистентность была в 2 раза ниже нормальной. По сравнению с нормальными значениями у больных группы 2 диаметр эритроцитов был увеличен на 18%, гематокрит — на 7%, механическая резистентность была снижена на 27%. У пациентов группы 3 деформируемость была снижена на 14%, диаметр эритроцитов превышал норму на 11%, гематокрит — на 5%, механическая резистентность была снижена на 18%. У больных группы 4 деформируемость эритроцитов была практически не нарушена, все остальные параметры эритроцитов также не отличались от нормальных. Заключение. Существуют как специфические факторы, обусловливающие нарушение деформируемости эритроцитов и присущие только конкретному заболеванию, так и общие факторы, изменяющие деформационные свойства эритроцитов, которые сопровождают практически любую патологию. Общими факторами, снижающими деформационные свойства эритроцитов при исследованных нами заболеваниях, являются выраженная диспротеинемия и ацидоз. Background. Blood flow disorders due to its viscosity increasing and erythrocytes elasticity decreasing, may cause significant disturbances of central hemodynamics and microcirculation that lead to organ dysfunction. Objectives: to studythe basic specific mechanisms of erythrocyte deformability impairment in various diseases. Patients/Methods. We examined 16 patients: with hemorrhagic pancreonecrosis (n = 16) without acute comorbid cardiovascular pathology (group 1); with thrombembolia of the main arteries (iliac, femoral and popliteal) of lower extremities (n = 37), and disease duration of 2 to 3 days (group 2); with acute thrombosis (II degree ischemia) of the main arteries in the lower extremities (n = 32), and disease duration from several weeks to several months (group 3); with acute venous thrombosis (n = 36) and disease duration from 24 hours to 30 days (group 4). Group 5 consisted of 26 practically healthy individuals. We measured erythrocytes deformability (by filterability method), erythrocytes diameter distribution, hematocrit and erythrocytes mechanical resistance, plasma proteins composition (spectrophotometrically), sialic acid concentration in plasma and erythrocytes. Results. The most expressive disorders of erythrocytes morphological and physicochemical properties were found in patients with hemorrhagic pancreonecrosis (group 1): erythrocytes filtration rate was 1.8 times less than in healthy people; erythrocytes diameter was 1.2 times and the hematocrit level was 9% above normal; mechanical resistance was 2 times lower than normal. In patients of group 2 erythrocytes diameter was increased by 18%, hematocrit level — by 7%, mechanical resistance was reduced by 27% compared with normal values. In patients of group 3, deformability was reduced by 14%, erythrocytes diameter exceeded the norm by 11%, the hematocrit was by 5% above the norm, mechanical resistance was reduced by 18%. In patients of group 4, erythrocyte deformability practically was not impaired; all other erythrocytes parameters also did not differ from normal values. Conclusions. Erythrocyte deformability impairment caused by both specific factors that are attributable only for specific disease and by common factors that exists in almost any disease. Expressed dysproteinemia and acidosis are common factors that reduce erythrocyte deformability in examined diseases.


2020 ◽  
Vol 40 (11) ◽  
pp. NP613-NP618
Author(s):  
Bilsev Ince ◽  
Munur Selcuk Kendir ◽  
Ibrahim Kilinc ◽  
Mustafa Cihat Avunduk ◽  
Mehmet Dadaci ◽  
...  

Abstract Background Although some studies in the literature report that autologous and homologous platelet-rich plasma (PRP) can be employed in the treatment of androgenic alopecia (AGA), no study, to the authors’ knowledge, has examined the estrogen concentration of prepared PRP. Objectives The authors aimed to determine the presence of estrogen in PRP and to investigate the effect of estrogen concentration of PRP on AGA treatment. Methods Between 2017 and 2018, 30 male patients with hair loss complaints were included in this prospective study. Autologous PRP was injected in patients in Group 1. Homologous PRP with high estrogen levels was injected in the patients in Group 2. PRP was injected in both groups 4 times at 0, 1, 3, and 6 months. The obtained photographs were evaluated and hair densities of each patient at controls were calculated. Results The mean estrogen level measured in PRP was statistically significantly higher in Group 2. In both groups, the increase in hair density was observed from the first month, but this increase was statistically significantly higher in all controls in Group 2. In Group 2, there was a statistically significant increase in the 1st and 3rd months compared with the previous control, but there was no difference between the 6th and 12th months and the 3rd month. Conclusions Increased hair density is greater and earlier in the group receiving estrogen-rich PRP than in the group utilizing autologous PRP. The authors think that estrogen-rich PRP may be employed in the treatment of AGA in the presence of an appropriate donor. Level of Evidence: 2


2019 ◽  
Vol 13 (2) ◽  
pp. 103-108 ◽  
Author(s):  
Gianpaolo Bragagni ◽  
Chiu Hua Chen ◽  
Federico Lari ◽  
Gaetano Magenta

This study evaluated the correlation between interatrial block (IAB) and atrial fibrillation (AF) among patients admitted to our Internal Medicine Unit: 110 (group 1) were identified with electrocardiograms both in sinus rhythm and AF, and 123 (group 2) constantly in sinus rhythm. In both groups we analyzed: the presence of partial (P≥120 msec) or advanced (P>120 msec and biphasic in D2, D3, aVF) IAB, and the main electrocardiographic and clinical features. Age and gender between the two groups were similar. IAB was present in 89/110 (80.91%) in group 1 and 26/123 (21.13%) in group 2 (P=<0.01); partial in 50/110 (45.45%) and 19/123 (15.7%) in group 1 and 2 respectively (P<0.01), advanced in 39/110 (35.45%) and 7/123 (5.69%) (P<0.019). The correlation between IAB and AF was significant (P<0.001); 36 (65.4%) patients out of 55 with atrial echo dilatation had IAB and 14 (25.4%) had deep terminal negativity of P-wave in V1 (DTNPV1) >0.1 mV (P<0.01). IAB represents a reliable predictor of AF; moreover, the sensitivity of the IAB in detecting atrial dilatation is higher than the DTNPV1 >0.1 mV.


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