Assessment of atrial conduction time in patients with essential hypertension

• Published in: Journal of electrocardiology 2011-03, Vol.44 (2), p.251-256
• Main Authors: Emiroglu, Mehmet Yunus, MD, Bulut, Mustafa, MD, Sahin, Müslim, MD, Acar, Gurkan, MD, Akcakoyun, Mustafa, MD, Kargin, Ramazan, MD, Kayancicek, Hidayet, MD, Karapinar, Hekim, MD, Aung, Soe Moe, MD
• Format: Article
• Language: English
• Subjects: Atrial electromechanical delay; Cardiovascular; Electrocardiography - methods; Electrophysiological study; Female; Heart Atria - physiopathology; Heart Conduction System - physiopathology; Humans; Hypertension; Hypertension - complications; Hypertension - diagnosis; Hypertension - physiopathology; Intra and inter atrial conduction time; Male; Middle Aged; P wave dispersion; Tissue Doppler imaging; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0022-0736; 1532-8430
• DOI: 10.1016/j.jelectrocard.2010.09.012

Abstract Background We aimed to assess atrial conduction time in patients with essential hypertension. Methods A total of 80 patients with hypertension (51 males/29 females, 53 ± 12.5 years) and 80 controls (50 males/30 females, 50 ± 12 years) were included. Atrial electromechanical coupling (time interval from the onset of P wave on surface electrocardiogram [ECG] to the beginning of A wave interval with tissue Doppler echocardiography [PA]), intraatrial and interatrial electromechanical delay (intra and inter atrial electromechanical delay [AEMD]), and P-wave dispersion (Pd) were measured (Appelton, C.P., Hatle, L., Popp, R.L., Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol. 1988; 12: 426-440). Results Atrial electromechanical coupling at the left lateral mitral annulus (PA lateral) and septal mitral annulus were longer in patients with hypertension (63.0 ± 8.0 vs 50.2 ± 4.3, P < .001, and 53.3 ± 6.2 vs 40.1 ± 5.5, P < .001). Interatrial (PA lateral–PA tricuspid) and intraatrial electromechanical delay (PA septum–PA tricuspid) were longer in patients with hypertension (24.8 ± 7.2 vs 12.4 ± 4.3, P < .001, and 14.1 ± 4.5 vs 2.3 ± 1.6, P < .001, respectively). Maximum P-wave duration and Pd were higher in patients with hypertension compared with controls (95.6 ± 8.0 vs 90.1 ± 9.5, P = .01, and 41.3 ± 7.1 vs 33.5 ± 6.1 P < .001, respectively). In correlation analysis, a positive correlation was detected between interatrial electromechanical delay and Pd ( r = 0.72, P < .001). There was a moderate correlation between left ventricular mass index and PA lateral ( r = 0.48, P < .001). Conclusion Our results revealed that interatrial electromechanical delay and Pd were prolonged in patients with hypertension. Our results also showed a correlation between interatrial electromechanical delay and Pd. Prolonged electromechanical delay and Pd found in hypertensive patients could be related with increased incidence of atrial fibrillation in these patients. Prospective studies are needed to document the association between intraatrial and interatrial electromechanical delays and the development of atrial fibrillation.