scholarly journals Echocardiography features in determining left atrial dilatation in patients with hypertension

2021 ◽  
Vol 8 (3) ◽  
pp. 5-13
Author(s):  
V. V. Kirillova
Keyword(s):  
Left Atrial ◽  
P Wave ◽  
Strong Positive Correlation ◽  
Wave Duration ◽  
Chamber View ◽  
P Wave Duration ◽  
Ambulatory Patients ◽  
Standard Lead ◽  
Design And Methods

Background. The correct echocardiographic (Echo) determination of left atrial (LA) dilatation is a criterion for diagnosing heart failure with the preserved ejection fraction.Objective. The aim is to detect probable reasons for underestimating the LA area by Echo in hypertension patients.Design and methods. In the prospective study, the LA area was measured echocardiographically in 89 ambulatory patients (P-wave duration in standard lead II was > 0.1 mm in 57 patients and ≤ 0.1 mm in 32 patients) from the apical four- and two-chamber views with and without focusing on the LA, and from the subcostal four-chamber view.Results. A strong positive correlation was detected between ECG P-wave duration and the Echo LA area (r = 0.74). The LA areas were revealed to be different in patients with P-wave duration over 0.1 mm from the apical fourchamber view with optimization of displaying the LA (22.33 ± 0.68 and 19.02 ± 0.56 cm2, respectively). The maximum LA area was detected from the subcostal fourchamber view (24.41 ± 0.78).Conclusion. Thus, using the correspondence between the LA area and Pwave duration in standard lead II, optimization of displaying the LA, and additionally measuring the LA dimensions from the subcostal view, sonologists can avoid underestimating LA dimensions.

scholarly journals Evaluation of left atrial mechanics and p-wave dispersion as markers of left atrial cardiopathy in patients of embolic stroke of undetermined source (ESUS)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Masood ◽  
M.M Azharuddin ◽  
S.M.K Ashraf ◽  
S Wahab
Keyword(s):  
Left Atrial ◽  
Wave Dispersion ◽  
Embolic Stroke ◽  
P Wave ◽  
Electromechanical Delay ◽  
P Wave Dispersion ◽  
Atrial Electromechanical Delay ◽  
Wave Duration ◽  
P Wave Duration ◽  
Increased Risk

Abstract Introduction Around 25% of all ischaemic strokes have no known cause despite standard investigations. Most of these cases are suspected to have an embolic source for ischaemia, leading to the moniker of Embolic Stroke of Undetermined Source (ESUS). Recent studies suggest that abnormalities of the left atrium, in the form of atrial cardiopathy, can lead to increased risk of stroke even in the absence of atrial fibrillation (AF), which may be either as precursors to AF or as independent risk factors for the development of left atrial thrombus and subsequent stroke. Purpose The aim of this study was to measure LA electromechanical dissociation, LA volumes and P-wave dispersion as markers of atrial cardiopathy in patients with ESUS to determine whether atrial cardiopathy may be in the causal pathway of ESUS. Methods 28 patients presenting with ischaemic stroke and fulfilling the criteria for ESUS were enrolled into this cross-sectional, observational study. All patients had 24-hour Holter monitoring done to rule out the presence of AF. The control group consisted of 28 age- and gender-matched apparently healthy individuals. On ECG, P-wave Dispersion (PWD) was calculated by subtracting minimum P-wave duration from maximum P-wave duration. On echocardiography, time intervals from the beginning of P-wave to beginning of A' wave from the lateral mitral annulus in tissue doppler imaging was measured as the atrial electromechanical delay. LA volumes were recorded using the Modified Biplane Simpson's method. Statistical analysis was performed using student's t-test, chi-square test, and Pearson's test. Results Baseline demographic and laboratory characteristics were similar between the two groups. Increased PWD (34.14±9.89 ms vs. 27.32±8.95 ms; p=0.01), atrial electromechanical delay (73.32±16.31 ms vs. 63.63±13.59 ms; p=0.02) and LA volumes were observed in patients with ESUS as compared to controls. A significant correlation was also found between these parameters (p<0.01). Discussion According to the results of our study, PWD, atrial electromechanical delay and LA volumes may be novel predictors for ESUS. Atrial cardiopathy is a unique mechanism of thrombo-embolism in ESUS patients and our data establishes its association with ESUS. Further studies will be needed to shed more light on its role in the causality of stroke in the ESUS population. Measurement of electromechanical delay Funding Acknowledgement Type of funding source: None

scholarly journals An Atrial Fibrillation with Normal Limits using Signal Processing- A Review

2018 ◽  
Vol 7 (2.24) ◽  
pp. 453
Author(s):  
S. Sathish ◽  
K Mohanasundaram
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
P Wave ◽  
Wave Duration ◽  
Normal Limits ◽  
Normal Sinus ◽  
P Wave Duration ◽  
Standard Lead ◽  
Wave Morphology

Atrial fibrillation is an irregular heartbeat (arrhythmia) that can lead to the stroke, blood clots, heart failure and other heart related complications. This causes the symptoms like rapid and irregular heartbeat, fluttering, shortness of breath etc. In India for every around 4000 people eight of them are suffering from Atrial Fibrillation. P-wave Morphology.  Abnormality of P-wave (Atrial ECG components) seen during sinus rhythm are associated with Atrial fibrillation. P-wave duration is the best predictor of preoperative atrial fibrillation. but the small amplitudes of atrial ECG and its gradual increase from isometric line create difficulties in defining the onset of P wave in the Standard Lead Limb system (SLL).Studies shows that prolonged P-wave have duration in patients (PAF) In this Study, a Modified Lead Limb (MLL) which solves the practical difficulties in analyzing the P-ta interval for both in healthy subjects and Atrial Fibrillation patients. P-Ta wave interval and P-wave duration can be estimated with following proposed steps which is applicable for both filtered and unfiltered atrial ECG components which follows as the clinical database trials. For the same the p-wave fibrillated signals that escalates the diagnosis follows by providing minimal energy to recurrent into a normal sinus rhythm.  

The impact of left atrial pressure on filtered P-wave duration in patients with atrial fibrillation

2016 ◽  
Vol 31 (11) ◽  
pp. 1848-1854 ◽  
Author(s):  
Hideyuki Kishima ◽  
Takanao Mine ◽  
Satoshi Takahashi ◽  
Kenki Ashida ◽  
Masaharu Ishihara ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
P Wave ◽  
Atrial Pressure ◽  
Left Atrial Pressure ◽  
Wave Duration ◽  
P Wave Duration ◽  
The Impact

Correlation of Left Atrial Size With P-Wave Duration in Interatrial Block

CHEST Journal ◽  
2005 ◽  
Vol 128 (4) ◽  
pp. 2615-2618 ◽  
Author(s):  
Vignendra Ariyarajah ◽  
Kristin Mercado ◽  
Sirin Apiyasawat ◽  
Puneet Puri ◽  
David H Spodick
Keyword(s):  
Left Atrial ◽  
P Wave ◽  
Left Atrial Size ◽  
Wave Duration ◽  
P Wave Duration ◽  
Atrial Size ◽  
Interatrial Block

scholarly journals Diagnostic performance of P wave duration in the identification of left atrial enlargement in dogs

2012 ◽  
Vol 53 (5) ◽  
pp. 267-272 ◽  
Author(s):  
P. Savarino ◽  
M. Borgarelli ◽  
A. Tarducci ◽  
S. Crosara ◽  
N. M. Bello ◽  
...  
Keyword(s):  
Left Atrial ◽  
Diagnostic Performance ◽  
P Wave ◽  
Left Atrial Enlargement ◽  
Wave Duration ◽  
P Wave Duration ◽  
Atrial Enlargement

scholarly journals P Wave Duration/P Wave Voltage Ratio Plays a Promising Role in the Prediction of Atrial Fibrillation: A New Player in the Game

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
E. Karacop ◽  
A. Enhos ◽  
N. Bakhshaliyev ◽  
R. Ozdemir
Keyword(s):  
Left Atrial ◽  
Left Atrial Volume ◽  
P Wave ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index ◽  
Wave Duration ◽  
Voltage Ratio ◽  
P Wave Duration ◽  
New Onset

Background. Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. Identification of patients at risk for developing AF and the opportunity for early targeted intervention might have a significant impact on morbidity and mortality. Prolonged P wave duration and decreased P wave voltage have been shown to be independent predictors of AF. The present study aimed to investigate the role of P wave duration/P wave voltage in predicting new-onset AF. Methods. We screened a total of 640 consecutive patients who admitted to cardiology outpatient clinic with a complaint of palpitation between 2012 and 2014. 24-h Holter monitoring, echocardiography, and electrocardiography (ECG) recordings were reviewed to identify new-onset AF. Patients were assigned into two groups based on presence (n = 150) and absence (n = 490) of new-onset AF. Previous ECGs with sinus rhythm were analyzed. P wave duration was measured in inferior leads, and P wave voltage was measured in lead one. P wave duration/P wave voltage was also calculated for each patient. Results. One hundred fifty subjects (23.4%) had new-onset AF among 640 patients. P wave duration (123.27 ± 12.87 vs. 119.33 ± 17.39 ms, p = 0.024 ) and P wave duration/P wave voltage (1284.70 ± 508.03 vs. 924.14 ± 462.06 ms/mV, p < 0.001 ) were higher, and P wave voltage (0.12 ± 0.04 vs. 0.13 ± 0.04 mV, p < 0.001 ) was significantly lower in the new-onset AF group compared with non-AFs. P wave duration/P wave voltage, with a cut off of 854.5 ms/mV, had 83.3% sensitivity and 62.0% specificity in a receiver operating characteristic curve (AUC 0.728, 95% CI 0.687–0.769; p < 0.001 ). Their negative and positive predictive values were 78.7% and 68.6%, respectively. In a univariate regression analysis, age, smoking, C-reactive protein, brain natriuretic peptide, left atrial diameter, left atrial volume index, P wave duration, P wave voltage, and P wave duration/P wave voltage were significantly associated with the development of new-onset AF. Moreover, smoking (OR 4.008, 95% CI 1.707–9.409; p = 0.001 ), left atrial volume index (OR 7.108, 95% CI 4.400–11.483; p < 0.001 ), and P wave duration/P wave voltage (OR 1.002, 95% CI 1.000–1.003; p = 0.044 ) were found to be significant independent predictors of new-onset AF in a multivariate analysis, after adjusting for other risk parameters. Conclusion. The P wave duration/P wave voltage ratio is a practical, easy-to-use, cheap, and reliable electrocardiographic parameter, which can play a promising role for both in predicting and elucidating a mechanism of new-onset AF.

Sign in / Sign up

Export Citation Format

Share Document