scholarly journals Atrial Electromechanical Delay Is Impaired in Patients with Primary Hyperparathyroidism

Author(s):  
Saban Kelesoglu ◽  
Yücel Yılmaz ◽  
FERHAT GOKAY ◽  
yasin simsek ◽  
BEKIR CALAPKORUR ◽  
...  

Aim: Primary hyperparathyroidism (PHPT) is an endocrine disease that poses a risk for cardiac arrhythmias. Atrial electromechanical delay (EMD) has been known as an early marker of atrial fibrillation (AF). This study aimed to evaluate the atrial EMD in PHPT. Methods: Fifty PHPT patients (45 females, 5 males) aged 30-75 years and 38 controls (35 females, 3 males) aged 31-73 years were included in the study. Atrial EMD parameters were measured by using tissue Doppler imaging (TDI). Inter-atrial EMD was calculated as the difference between PA lateral and PA tricuspid, intra-atrial EMD was calculated as the difference between PA septum and PA tricuspid, and left-atrial EMD was calculated as the difference between PA lateral and PA septum Results: Atrial EMD parameters (PA lateral, PA septum, PA tricuspid) significantly increased in PHPT group compared to control group (p<0.001, for all). Also, inter-atrial and intra-atrial EMD were higher in PHPT group compared to control group (p<0.001, for all). In correlation analysis, calcium was well associated with PA lateral (r=0.748, p<0.001), PA septum (r = 0.720, p <0.001), inter-atrial EMD (r = 0.670, p <0.001) and intra-atrial EMD (r = 0.616, p <0.001). There was the same correlation relationship between PTH levels with PA lateral (r=671, p<0.001), PA septum (r=0.660, p<0,001), inter-atrial EMD (r=0.674, p<0,001) and intra-atrial EMD (r=0.732, p<0.001) Conclusions: Atrial EMD parameters were prolonged in PHPT. The measurement of atrial EMD parameters might be used to determine the risk of development of AF in PHPT

2021 ◽  
Vol 74 (10) ◽  
pp. 2605-2609
Author(s):  
Tetyana M. Ternushchak ◽  
Marianna I. Tovt-Korshynska

The aim: To evaluate P-wave dispersion (PwD), as an independent predictor of atrial fibrillation, corrected QT interval dispersion (cQTD), the noninvasive marker of ventricular arrhythmia and sudden cardiac death, investigate the atrial electromechanical delay in patients with COPD and assess their relation with the severity of the disease. Materials and methods: We prospectively enrolled consecutive patients with newly diagnosed COPD (n = 53, age 41.2 ± 6.8 years), compared with an age-matched healthy control group (n = 51, age 40.9 ± 6.5 years). A standard 12-lead electrocardiogram of each patient was analyzed for PwD and сQTD. Atrial electromechanical delay was analyzed by echocardiographic tissue Doppler imaging. The difference between PAs-PAl, PAs-PAt, and PAl-PAt were defined as left intra-atrial, right intra-atrial, and interatrial electromechanical delays (EMD), respectively. Results: PwD was higher in COPD patients than in control subjects (39.47 ± 3.12 ms vs. 30.29 ± 3.17 ms, p < 0.05). In comparison between control group and COPD subgroups (mild, moderate and severe), there was a statistically significant difference among these free groups in terms of PwD. Subgroup analyses showed that this difference was mainly due to patients with severe COPD. Regarding cQTD, there was a statistically significant increase in COPD patients 57.92 ± 3.43 ms vs 41.03 ± 5.21 ms, p < 0.05 respectively. PAs, PAl and PAt durations, right intra-atrial and interatrial EMD were also significantly longer in COPD patients (p < 0.05). Furthermore, there were significant negative correlations between FEV1 and PwD (r = – 0.46, p < 0.05), right intra-atrial (r = – 0.39 ms, p < 0.05), interatrial EMD ( r = – 0.35 ms, p < 0.05) and cQTD (r = – 0.32, p < 0.05). Conclusions: Atrial conduction time, such as inter- and intra-atrial EMD intervals, PwD and cQTD were longer than in healthy controls and correlated with the severity of COPD. These parameters offer a non-invasive and cost-effective assessment method for detecting patients at high risk of arrhythmia. Nevertheless, further prospective investigations on this issue are required.


2020 ◽  
Author(s):  
Kanako Akamatsu ◽  
Takahide Ito ◽  
Masatoshi Miyamura ◽  
Yumiko Kanzaki ◽  
Koichi Sohmiya ◽  
...  

Abstract Background: Tissue Doppler imaging (TDI)-derived atrial electromechanical delay (AEMD), has been reported to be useful for predicting development of atrial fibrillation (AF). However, its usefulness remains unknown when analyzed along with patients seemingly at high-risk for AF as controls. From this standpoint, we investigated whether AEMD would be of use for identifying patients with paroxysmal AF (PAF). Methods: We analyzed TDI recordings to obtain AEMD in 73 PAF patients. Thirty-nine patients with multiple cardiovascular risk factors (MRFs) but without history of AF and 61 healthy individuals served as disease and healthy controls, respectively. AEMD was defined as the time-interval between the electrocardiogram P-wave and the beginning of the spectral TDI-derived A’ for the septal (septal EMD) and lateral (lateral EMD) sides of the mitral annulus. Results: There was no significant difference in the left atrial volume index between PAF patients and disease controls (28 ± 5 mL/m2 vs. 27 ± 5 mL/m2). PAF patients had longer AEMD, particularly for the lateral EMD (78 ± 26 ms), compared with disease (62 ± 21 ms, P = 0.003) and healthy (53 ± 24 ms, P <0.001) controls. Multivariate logistic regression analysis revealed that the lateral EMD (OR 1.42, 95%CI 1.16 – 1.75, P <0.001), along with the left atrial volume index (OR 2.86, 95%CI 1.70 – 4.80, P <0.001), was one of the significant independent associates of identifying PAF patients. Conclusions: According to our data, analyzed along with MRFs patients, AEMD seems to be a useful index of identifying patients at risk for AF.


2020 ◽  
Author(s):  
Kanako Akamatsu ◽  
Takahide Ito ◽  
Masatoshi Miyamura ◽  
Yumiko Kanzaki ◽  
Koichi Sohmiya ◽  
...  

Abstract Background: Tissue Doppler imaging (TDI)-derived atrial electromechanical delay (AEMD) has been reported to be useful for detecting paroxysmal atrial fibrillation (PAF). However, its usefulness remains unknown when analyzed along with patients seemingly at high-risk for AF as controls. From this standpoint, we investigated whether AEMD would be of use for identifying patients with PAF. Methods: We retrospectively analyzed TDI recordings to obtain AEMD in 63 PAF patients. Thirty-three patients with multiple cardiovascular risk factors (MRFs) but without history of AF and 50 healthy individuals served as disease and healthy controls, respectively. AEMD was defined as the time-interval between the electrocardiogram P-wave and the beginning of the spectral TDI-derived A’ for the septal (septal EMD) and lateral (lateral EMD) sides of the mitral annulus. Results: There was no significant difference in the left atrial volume index between PAF patients and disease controls (28 ± 9 mL/m 2 vs. 27 ± 5 mL/m 2 ). PAF patients had longer AEMD, particularly for the lateral EMD (75 ± 23 ms), compared with disease (62 ± 22 ms, P = 0.009) and healthy (54 ± 24 ms, P <0.001) controls. Multivariate logistic regression analysis revealed that the lateral EMD (OR 1.25, 95%CI 1.03 – 1.52, P = 0.023), along with the left atrial volume index (OR 2.25, 95%CI 1.44 – 3.51, P <0.001), was one of the significant independent associates of identifying PAF patients. Conclusions: This cross-sectional study indicates that even analyzed together with MRFs patients, AEMD remains useful for identifying patients at risk for AF. Our results need to be confirmed by a large-scale prospective study.


EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M Parollo ◽  
G Zucchelli ◽  
V Barletta ◽  
V Della Tommasina ◽  
A Canu ◽  
...  

Abstract Background Atrial electromechanical delay, assessed calculating the PA-TDI interval using tissue Doppler imaging, is a known and promising determinant for atrial fibrillation recurrence prediction after pulmonary vein isolation and electrical cardioversion. Purpose To determine the relationship between atrial electromechanical delay and the presence of atrial fibrillation. Methods We prospectively enrolled patients presenting at our Unit in sinus rhythm scheduled for an arrhythmogenic substrate ablation (atrial fibrillation -AF-, supraventricular tachycardia -SVT- and premature ventricular contractions -PVC-). Demographic and echocardiographic characteristics were evaluated upon admission. Atrial electromechanical delay was inferred via the PA-TDI interval, obtained by calculating the time difference between the P wave onset and the A" wave peak on TDI recordings. Results From October 2018 to August 2019, 200 patients (60% male, mean age 58,21 ± 14,26, mean BSA 1,9 ± 0,21 m2, mean BMI 26,42 ± 6,28 kg/m2, mean EF 60,91% ± 5,43%) were admitted to our unit to undergo AF (group 1: n = 145; 72,50%), SVT or PVC ablation (group 2: n = 55; 27,5%). Compared with the control group (group 2), patients admitted for AF ablation had a larger LA size (group 1 vs group 2: mean LA area 23,21 ± 5,07 vs 16,87 ± 4,01 cm2, p &lt; 0,001; mean indexed LA volume 46,71 ± 20,41 ml vs 32,04 ± 14,7 ml, p &lt; 0,001; mean LAD 41,77 ± 5,66 vs 33,84 ± 6,06, p &lt; 0,001) and a longer PA-TDI interval (lateral 148,55 ± 28,5 vs 128,57 ± 20,9, p &lt; 0,001; medial 125,34 ± 21,02 vs 109,11 ± 21,49, p &lt; 0,001; average 141,43 ± 27,58 vs 119,08 ± 18,63, p &lt; 0,001). Conclusion The PA-TDI interval is a non-invasive and easily achievable echocardiographic parameter, which is demonstrated to be prolonged in patients with a history of AF in contrast with patients with other arrhythmias, as expression of atrial conduction heterogeneity. Abstract Figure. PA-TDI measurement


Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 228 ◽  
Author(s):  
Fatih Temiz ◽  
Hatice Güneş ◽  
Hakan Güneş

Background and Objective: Childhood obesity is one of the worldwide health problems with an increasing prevalence and accompanied by severe morbidity and mortality. It is a serious predisposing risk factor especially for the development of cardiovascular diseases and arrhythmias. Electromechanical delay (EMD) is known to be a predictor for the development of atrial fibrillation (AF). Our study aims to investigate whether EMD, which is a predictor of AF, prolongs in obese children or not. Material and Methods: The study included 59 obese patients aged between 8–18 years and 38 healthy patients as the control group with a similar age and gender. All the individuals underwent transthoracic echo and tissue Doppler echocardiography. Systolic and diastolic left ventricular (LV) functions, inter- and intra-atrial electromechanical delay were measured by tissue Doppler imaging (TDI) and conventional echocardiography. Results: Obese patients had significantly lengthened P-wave on surface ECG to the beginning of the late diastolic wave (PA) lateral, PA septum, intra- and inter-atrial electromechanical delays when compared with the control group (p < 0.001, p = 0.001, p < 0.001 and p < 0.001, respectively) Inter-atrial EMD and intra-atrial EMD correlated positively with body mass index (BMI) values (r = 0.484, p < 0.001 and r = 0.376, p = 0.001; respectively) BMI was significantly related with inter-atrial EMD (β = 0.473, p < 0.001) However, there was no relationship between inter-atrial EMD and serum glucose and platelet count. Conclusion: In our study, we declared that electromechanical delay was increased in obese children when compared to the control group and intra- and inter-atrial electromechanical delay was in correlation with body mass index. Furthermore, we discovered that BMI is an independent predictor of the inter-atrial EMD in obese children.


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