Vessel heterogeneity of TIMI frame count and its relation to P-wave dispersion in patients with coronary slow flow

Coronary slow flow is a rare, clinically important entity observed in acute coronary syndrome. The pathophysiological mechanism is not fully elucidated. We investigated patients with chest pain who had angiographic features consistent with the coronary slow flow. One hundred ten patients were included. Electrocardiography, echocardiography, and angiography results were retrospectively noted. The mean age was 56.4. Fifty-eight were male, and fifty-two were female. The control group consisted of patients with normal angiography. Patients had higher diastolic blood pressure, lower mean ejection fraction, higher average left ventricular end-diastolic diameter, and higher mean left atrial size than the control group (p=0.009,p=0.017,p=0.041,andp<0.001, resp.). Patients had higher average V1 ID, V6 ID, P wave dispersion, TFC LAD, TFC Cx, TFC RCA, and TFC levels than the control group. A significant linear positive relationship was found between the V1 ID and the TFC LAD, TFC Cx, TFC RCA, and TFC; also between the V6 ID and the TFC LAD, TFC Cx, TFC RCA, and TFC. Angiographic and electrocardiographic features are suggestive and diagnostic for the coronary slow flow syndrome. Although when regarded as a benign condition, coronary slow flow should be diagnosed, followed up, and treated as many of laboratory features suggest ischemic events.

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Determination of the relationship between the coronary slow flow phenomenon, and the P wave dispersion and QT dispersion

Kafkas Journal of Medical Sciences ◽

10.5505/kjms.2012.55265 ◽

2012 ◽

Vol 2 (2) ◽

pp. 49-53 ◽

Cited By ~ 1

Author(s):

Yuksel Kaya ◽

Ali Kemal Gur ◽

Edip Gonullu ◽

Tolga Sinan Guvenc ◽

Ahmet Karakurt ◽

...

Keyword(s):

Qt Dispersion ◽

Wave Dispersion ◽

P Wave ◽

Slow Flow ◽

P Wave Dispersion ◽

Flow Phenomenon ◽

Coronary Slow Flow ◽

Coronary Slow Flow Phenomenon ◽

The Relationship

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Electrocardiography Predictive Value on Coronary Slow Flow Phenomenon

BioScientia Medicina ◽

10.37275/bsm.v6i3.454 ◽

2022 ◽

Vol 6 (3) ◽

pp. 1435-1442

Author(s):

Erwin Sukandi ◽

Yudhie Tanta ◽

Taufik Indrajaya ◽

Ali Ghanie ◽

Muhammad Irsan Saleh ◽

...

Keyword(s):

Coronary Angiography ◽

Coronary Vessels ◽

P Wave ◽

Attractive Alternative ◽

Slow Flow ◽

P Wave Dispersion ◽

Diagnostic Modality ◽

Flow Phenomenon ◽

Coronary Slow Flow ◽

Coronary Slow Flow Phenomenon

Coronary Slow Flow Phenomenon (CSFP) is characterized by the slow flow of contrast in one or more epicardial coronary vessels without evidence of coronary artery stenosis during coronary angiography procedures. CSFP is fairly common at the time of elective angiography with an incidence of around 7% and accounts for about 4% of hospitalized unstable angina cases. Coronary angiography is currently still the only effective way to detect CSFP, but this procedure is an invasive procedure with high costs, there is a risk of allergy to contrast. Electrocardiography (ECG), as a widely available, inexpensive, and simple modality is felt to be an attractive alternative in early detection of this abnormality. The ECG parameters on CSFP discussed in this study include; p-wave dispersion, QT interval dispersion, QRS intrinsic (Tpeak-Tenddeflection duration), and QRS fragmentation. Further studies are needed on the ECG image in CSFP so that in the future ECG can be a cheaper and non-invasive diagnostic modality for CSFP compared to coronary angiography.

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806 P wave dispersion is correlated with diastolic dysfunction in patients with sarcoidosis

EP Europace ◽

10.1016/s1099-5129(05)80547-1 ◽

2005 ◽

Vol 7 ◽

pp. 186-186

Keyword(s):

Diastolic Dysfunction ◽

Wave Dispersion ◽

P Wave ◽

P Wave Dispersion

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TO STUDY THE EFFECT OF BMV ON P WAVE DISPERSION AND SHORT TERM PROGNOSTIC IMPACT OF P WAVE DISPERSION IN PREDICTION OF CLINICAL OUTCOME AFTER PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY IN PATIENTS WITH MITRAL STENOSIS AND SINUS RHYTHM

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i9.1397 ◽

2020 ◽

Vol 4 (9) ◽

Author(s):

Ashish Kumar Agarwal ◽

Daulat Singh Meena ◽

Vijay Pathak ◽

Anoop Jain ◽

Rakesh Kumar Ola

Keyword(s):

Clinical Outcome ◽

Right Ventricular ◽

Wave Dispersion ◽

Tissue Doppler ◽

P Wave ◽

Short Term ◽

P Wave Dispersion ◽

Mitral Valvuloplasty ◽

Percutaneous Balloon ◽

Before And After

Background: The aim of the present study was to study the effect of percutaneous balloon mitral valvuloplasty (PBMV) on P wave dispersion and to test the correlation between P-maximum and P-dispersion to right ventricular function and pulmonary artery pressure before and after PMBV. Also to study the impact of P-maximum and P-wave dispersion on the short term clinical outcome after successful PBMV in patients with mitral stenosis (MS) and sinus rhythm. Methods: 75 patients undergoing PMBV were enrolled in this study. We evaluated P-maximum, P-minimum and P-wave dispersion before and one month and one year after PBMV . We studied the changes in pulmonary arterial pressure (PAP), left atrial (LA) dimension, mitral diastolic gradient, and mitral valve area, in addition to the changes in right ventricular function utilizing tissue Doppler assessment both before and after PMBV, in addition the role of the P-wave dispersion in prediction of late cardiac events. Results: There were significant decrease in mean diastolic gradient, PAP, and LA size and significant improvement in right ventricular tissue Doppler indices after PMBV. Accompany these hemodynamic changes after PMBV. P-maximum and P-wave dispersion were found to be decreased (P < 0.001). Conclusion: Successful PBMV was associated with a decrease in Pmax and PWD. These simple electrocardiographic indices may predict the success of the procedure immediately after PBMV. The P-maximum and P-wave dispersion changes were correlated with significant impairment of right dysfunction and the degree of pulmonary artery pressure. Keywords: PBMV.PAP,LA

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

European Heart Journal ◽

10.1093/ehjci/ehaa946.2437 ◽

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

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