Original article
Doppler Tissue Evaluation of Intra-atrial and Interatrial Electromechanical Delay and Comparison with P-wave Dispersion in Patients with Mitral Stenosis

https://doi.org/10.1016/j.echo.2005.01.015Get rights and content

Objective

The aim of our study was to: (1) measure atrial electromechanical delay in patients with mitral stenosis (MS) and in a control group; (2) find the echocardiographic parameters that affect atrial electromechanical delay; and (3) examine the correlation between atrial electromechanical delay and P-wave dispersion (PWD).

Methods

A total of 25 patients with pure MS (age 43 ± 10 years; 18 women, 7 men) and 16 control subjects (age 41 ± 8 years; 9 women, 7 men) were studied. Interatrial and intra-atrial electromechanical delay was measured with Doppler tissue echocardiography. From the 12-lead electrocardiograms, PWD was calculated.

Results

Interatrial electromechanical delay was 71.2 ± 33 in the MS group and 40.5 ± 21.0 in the control group (P = .01). In the MS group, PWD was 50 ± 7 and in the control group it was 29 ± 5 (P = .03). A positive correlation was detected between interatrial electromechanical delay and PWD (r = 0.6, P = .03).

Conclusion

This study shows that interatrial electromechanical delay gets longer in MS and is correlated with PWD. Atrial electromechanical delay is related with left atrial size but not with severity of MS.

Section snippets

Methods

For this study, 25 patients with pure MS (age 43 ± 10 years; 18 women, 7 men) and 16 control subjects (age 41 ± 8 years; 9 women, 7 men) were studied. All patients were in sinus rhythm, in New York Heart Association class I or II, and not using β-blockers or digitalis derivatives. None of the patients had pacemakers. A complete transthoracic echocardiographic evaluation was performed using commercially available ultrasonographic equipment (System Five, GE Vingmed Ultrasound, Horten, Norway). A

Results

Baseline characteristics were shown in Table 1. There were no significant differences with respect to age, heart rate, blood pressure, LV end-diastolic and end-systolic diameter, and LV ejection fraction.

Echocardiographic parameters of the LA are summarized in Table 2. LA maximum and minimum diameter, and maximum and minimum area, were significantly higher in patients with MS compared with control subjects (Table 2).

Table 3 displays the left and right electromechanical intervals for the control

Discussion

Atrial conduction disorders are frequent for patients with mitral valve disease. The resultant electrophysiologic and electromechanical abnormalities caused by atrial conduction abnormalities are associated with a higher risk of atrial fibrillation.1 This study has demonstrated for the first time that atrial electromechanical delay measured with Doppler tissue gets longer in MS.

Atrial electromechanical delay can be evaluated with invasive and noninvasive methods. Wang et al5 were the first to

Cited by (122)

  • Assessment of interatrial dyssynchrony by Tissue Doppler Imaging in mitral stenosis: Effect of afterload reduction after balloon mitral valvuloplasty

    2016, Egyptian Heart Journal
    Citation Excerpt :

    In our study, we found significant positive correlation between echocardiographic interatrial EMD and both electrocardiographic AF markers (P-max and PWD) (p < 0.05). Our results are in agreement with Özer et al.3 who used this TDI method for investigating interatrial EMD in patients with MS, and they detected a positive correlation between interatrial EMD and LA size, as well as between interatrial EMD and electrocardiographic AF markers (P-max and PWD). In addition to the small sample size, there are some limitations of our study.

View all citing articles on Scopus
View full text