scholarly journals Evaluation of P wave Dispersion and Tissue Doppler Imaging for Predicting Paroxysmal Atrial Fibrillation in Patients with Hypertension

2018 ◽  
Vol 21 (1) ◽  
pp. 054 ◽  
Author(s):  
Xiaohui Zhang ◽  
Wei Zeng ◽  
Yuanmin Li ◽  
Dapeng Hou ◽  
Xiuchang Li ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Tissue Doppler Imaging ◽  
Paroxysmal Atrial Fibrillation ◽  
Predictive Value ◽  
Wave Dispersion ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
P Wave ◽  
Doppler Imaging ◽  
P Wave Dispersion

Background: There are no previous studies dealing with paroxysmal atrial fibrillation (AF) and hypertension using electrocardiogram and tissue doppler imaging (TDI). The aim of this study was to investigate and identify the predictive indicators for paroxysmal AF in hypertensive patients using P wave dispersion (Pd) and TDI.Methods: Patients with hypertension were enrolled. Patients with paroxysmal AF were classified as the PAF group, and patients without a history of paroxysmal AF were classified as the NAF group. The clinical data, P wave indicators and TDI indicators were collected and compared between the two groups.Results: A total of 120 patients were enrolled into the study with 40 cases in the PAF group and 80 cases in the NAF group. Compared with NAF group, Pd, maximum P wave duration (Pmax), left ventricular end-diastolic dimension (LVEDd) and left atrial dimension (LAD) were significantly longer (P < .05) in the PAF group. PAL, PAI, PAR, LR, LI and IR were significantly longer (P < .05) in the PAF group than in the NAF group. As for ROC analysis, Pd and PAL had the greatest area under the curve. The best diagnostic value of Pd and PAL was 40ms and 78ms, respectively. The combination of Pd ≥40ms with Pmax ≥ 110ms showed higher specificity and positive predictive value but decreased sensitivity and negative predictive value for paroxysmal AF.Conclusions: The PAF group had significantly longer atrial electromechanical time and higher Pd compared with NAF group. The combination of Pd and TDI may be helpful to predict the onset of paroxysmal AF in patients with hypertension.

P Wave Dispersion in Hypertensive Patients with Paroxysmal Atrial Fibrillation

2000 ◽  
Vol 23 (11P2) ◽  
pp. 1859-1862 ◽  
Author(s):  
NECLA ÖZER ◽  
KUDRET AYTEMIR ◽  
ENVER ATALAR ◽  
ELIF SADE ◽  
SERDAR AKSÖYEK ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Wave Dispersion ◽  
P Wave ◽  
P Wave Dispersion ◽  
Hypertensive Patients

Signal Averaged P Wave Dispersion: A New Marker for Predicting the Risk of Paroxysmal Atrial Fibrillation

2002 ◽  
Vol 32 (4) ◽  
pp. 339 ◽  
Author(s):  
Woong Kim ◽  
Dong Gu Shin ◽  
Gue Ru Hong ◽  
Jong Seon Park ◽  
Young Jo Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Wave Dispersion ◽  
P Wave ◽  
P Wave Dispersion

The Relationship Between Prolidase Activity and Atrial Electromechanical Changes in Patients with Paroxysmal Atrial Fibrillation

2019 ◽  
Vol 22 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Mustafa Begenc Tascanov
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Collagen Synthesis ◽  
P Wave ◽  
Doppler Imaging ◽  
Atrial Remodeling ◽  
Conduction Time ◽  
Electromechanical Delay ◽  
P Wave Dispersion ◽  
Prolidase Activity

Background:Tissue fibrosis increases in the structure of the atrial tissue of atrial fibrillation patients. Prolidase enzyme regulates collagen synthesis. There may be an association between electrocardiography (ECG) findings and prolidase activity.Objective:This study investigated the association between atrial conduction time and prolidase activity, a collagen synthesis enzyme, and P-wave dispersion (PWD) in patients with Paroxysmal Atrial Fibrillation (PAF).Methods:Exclusion criteria included the age of <18 years, heart failure, diabetes, hypertension, hyperlipidemia, malignancy, cerebrovascular disease, chronic respiratory distress, osteoporosis, rheumatoid arthritis, renal disease, cirrhosis, and other types of arrhythmia. Patients diagnosed with PAF within 48 hours were considered to have a definite diagnosis. PWD was calculated using a 12-lead ECG, and inter- and intraatrial electromechanical delay (EMD) was assessed using tissue Doppler imaging and conventional echocardiography. Serum prolidase levels were measured in both groups.Results:A total of 43 patients with PAF (20 female, 23 male; mean age, 46.8 ± 5.7 years) and 42 healthy volunteers (21 female, 21 male; mean age, 43.9 ± 5.1 years) were included in the study.:Inter- and intraatrial EMD, PWD, minimum P-wave (Pmin), and maximum P-wave (Pmax) measurements were significantly higher (39.7 ± 2.7, 35.7 ± 2.3, p < 0.001; 13.2 ± 2.6, 8.5 ± 1.9, p < 0.001; 47.1 ± 11, 24.1 ± 7.1, p < 0.001; 69.8 ± 8.8, 66.7 ± 10.2, p < 0.130; 114.8 ± 13, 93.6 ± 8.6, p < 0.001, respectively) and serum prolidase levels were significantly lower in patients with PAF compared to healthy controls (3.96 ± 1.2, 8.5 ± 3.56, p < 0.001). In patients with PAF, correlation analysis showed a negative correlation between prolidase levels and intra- and interatrial EMD, PWD, and Pmax (r = -0.41, p < 0.05; r = -0.54, p < 0.05; r = -0.62, p < 0.05; r = -0.49, p < 0.05, respectively). Interatrial EMD showed a significant positive correlation with intraatrial EMD, Pmax, and PWD in patients with PAF (r = 0.90, p < 0.05; r = 0.574, p < 0.05; r = 0.43, p < 0.05, respectively). Additionally, the level of high-sensitivity C-reactive protein (hs-CRP) was significantly higher in patients with PAF (6.6 ± 8, 1.8 ± 1.6, p < 0.001).Conclusion:The decreased plasma prolidase activity in patients with PAF may explain the irregularity of the collagen metabolism of different extracellular components and may indicate the onset of atrial remodeling. Changes in PWD, interatrial EMD, and serum prolidase level may predict PAF before diagnosis.

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