Turk Kardiyol Dern Ars. 2020; 48(3): 263-269 | DOI: 10.5543/tkda.2019.58665
Assessment of atrial electromechanical delay and P wave dispersion in patients with chronic obstructive pulmonary disease
, Sermin Borekci2
, Burcak Kilickiran Avci3
, Ergi Hysi4
, Hurrem Gul Ongen2
, Bilgehan Karadag3
, Ozge Ozden Tok5
, Eser Durmaz3
, Hakan Karpuz31
Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland2
Department of Chest Diseases, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey3
Department of Cardiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey4
Department of Chest Diseases, Medicana Bahçelievler Hospital, İstanbul, Turkey5
Department of Cardiology, Memorial Bahçelievler Hospital, İstanbul, Turkey
OBJECTIVE Chronic obstructive pulmonary disease (COPD) is associated with atrial fibrillation (AF) and reduced forced expiratory volume (FEV1) is an independent predictor for new onset AF. The aims of this study were (1) to analyze the atrial electromechanical delay (AEMD) and P wave dispersion which are two predictors of AF development in patients with COPD and without any cardiovascular disease, and (2) to assess the relationship of those with pulmonary functions as quantified by FEV1 measurements.
METHODS The study included 41 patients with COPD (33 male; mean age: 51 years) and 32 healthy controls. P wave dispersion was calculated as the difference between the maximum and minimum P wave duration in a 12-lead surface electrocardiography (ECG) recording. AEMD, defined as the time interval from the P wave onset on the ECG to the initiation of the late diastolic (Am) wave using a tissue Doppler examination, was measured from the lateral mitral annulus (LAEMD), septal annulus (SAEMD), and tricuspid lateral annulus (TAEMD).
RESULTS P wave dispersion was significantly longer in the COPD group than those in the controls (76±19 ms vs. 45±10 ms; p<0.001). All of the AEMD measurements demonstrated significant prolongation in patients with COPD (LAEMD: 74±9 ms vs. 64±11 ms; SAEMD: 66±10 ms vs. 57±12 ms; and TAEMD: 65±9 ms vs. 46±7 ms; p<0.001 for all). The only correlation with FEV1 was observed in the TAEMD values of the COPD group (rs: -401; p<0.009).
CONCLUSION Both P wave dispersion and AEMD parameters were significantly longer in COPD patients without any established structural or functional cardiac abnormalities, indicating an increased tendency for AF development, beginning from the initial stages of the disease.
Atrial electromechanical delay, atrial fibrillation; chronic obstructive pulmonary disease.
How to cite this article
Murat Cimci, Sermin Borekci, Burcak Kilickiran Avci, Ergi Hysi, Hurrem Gul Ongen, Bilgehan Karadag, Ozge Ozden Tok, Eser Durmaz, Hakan Karpuz. Assessment of atrial electromechanical delay and P wave dispersion in patients with chronic obstructive pulmonary disease. Turk Kardiyol Dern Ars. 2020; 48(3): 263-269
Corresponding Author: Murat Cimci, Switzerland