Atrial Electromechanical Delay Is Impaired in Patients with Primary Hyperparathyroidism

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

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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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P wave dispersion and atrial electromechanical delay: do they vary with the extent of mitral annular calcification?

Acta Cardiologica ◽

10.1080/ac.71.4.3159698 ◽

2016 ◽

Vol 71 (4) ◽

pp. 449-455 ◽

Cited By ~ 2

Author(s):

Inas Eweda ◽

Mona Abul-Saud ◽

Hany Fouad ◽

Rania N. Hanna ◽

Wail Nammas

Keyword(s):

Wave Dispersion ◽

P Wave ◽

Mitral Annular Calcification ◽

Electromechanical Delay ◽

P Wave Dispersion ◽

Atrial Electromechanical Delay ◽

Annular Calcification

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RISK PREDICTION FOR ARRHYTHMIA IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Wiadomości Lekarskie ◽

10.36740/wlek202110214 ◽

2021 ◽

Vol 74 (10) ◽

pp. 2605-2609

Author(s):

Tetyana M. Ternushchak ◽

Marianna I. Tovt-Korshynska

Keyword(s):

P Wave ◽

Doppler Imaging ◽

Control Group ◽

Chronic Obstructive ◽

Conduction Time ◽

Electromechanical Delay ◽

P Wave Dispersion ◽

Atrial Electromechanical Delay ◽

Copd Patients ◽

Significant Difference

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.

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Atrial electromechanical delay in patients with chronic obstructive pulmonary disease in acute and stable periods

Cardiologia Croatica ◽

10.15836/ccar2019.229 ◽

2019 ◽

Vol 14 (9-10) ◽

pp. 229-229

Author(s):

Gokhan Perincek ◽

Sema Avci ◽

Ferdi Kahraman

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Electromechanical Delay ◽

Obstructive Pulmonary Disease ◽

Atrial Electromechanical Delay

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Atrial Electromechanical Delay in Healthy Individuals in Fasting and Postprandial States

World Journal of Cardiovascular Diseases ◽

10.4236/wjcd.2020.102005 ◽

2020 ◽

Vol 10 (02) ◽

pp. 41-49

Author(s):

Islam M. Sharaf ◽

Ahmed I. Bedier ◽

Hisham M. Wali

Keyword(s):

Healthy Individuals ◽

Electromechanical Delay ◽

Atrial Electromechanical Delay

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Predictive Value of Atrial Electromechanical Delay on Long-Term Cardiovascular Outcomes in Hemodialysis Patients

American Journal of Nephrology ◽

10.1159/000441099 ◽

2015 ◽

Vol 42 (3) ◽

pp. 239-249 ◽

Cited By ~ 2

Author(s):

Kultigin Turkmen ◽

Levent Demirtas ◽

Ergun Topal ◽

Abduzhappar Gaipov ◽

Ismail Kocyigit ◽

...

Keyword(s):

Regression Analysis ◽

Total Cholesterol ◽

Cox Regression ◽

Healthy Individuals ◽

Electromechanical Delay ◽

Cox Regression Analysis ◽

Atrial Electromechanical Delay ◽

Kaplan Meier ◽

All Cause Mortality ◽

Spearman Test

Background: Atrial electromechanical delay (AEMD) times were considered independent predictors of cardiovascular morbidity among the general population. We aimed at evaluating AEMD times and other risk factors associated with 2-year combined cardiovascular (CV) events in HD patients. Material and Methods: Sixty hemodialysis (HD) and 44 healthy individuals were enrolled in this prospective study. Echocardiography was performed before the mid-week dialysis session for HD patients. Data were expressed as mean ± SD. Spearman test was used to assess linear associations. Survival was examined with the Kaplan-Meier method. Multivariate Cox regression analysis was used to determine the predictors of combined CV events in this cohort. Results: At the beginning of the study, left intra-atrial-AEMD times were significantly longer in HD patients compared to the left intra-atrial-AEMD times in healthy individuals. After 24 months, 41 patients were still on HD treatment and 19 (31.6%) had died. Serum triglyceride, total cholesterol and albumin were found to be higher and C-reactive protein (CRP) levels, left intra-atrial EMD time (LIAT) and interatrial EMD times were found to be lower in survived HD patients. With the cut-off median values of 3.5 g/dl for albumin, 0.87 mg/dl for CRP, 157 mg/dl for total cholesterol and 151 mg/dl for triglyceride, the Kaplan-Meier curves demonstrated significant differences in terms of all-cause mortality. We also demonstrated the Kaplan-Meier survival curves of HD patients according to tertile values of LIAT. Cox regression analysis revealed that increased CRP and higher LIAT were found to be independent predictors of combined CV events. Conclusions: Increased LIAT and inflammation were found to be closely associated with 2 years combined CV events and all-cause mortality in HD patients.

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