P wave dispersion in patients with rheumatoid arthritis: its relation with clinical and echocardiographic parameters

Güler, Hayal; Seyfelì, Ergün; Şahin, Günşah; Duru, Mehmet Emin; Akgül, Ferit; Sağlam, Hayrettin; Yalçın, Fatih

doi:10.1007/s00296-007-0307-8

Cited by 32 publications

(21 citation statements)

References 34 publications

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“…Higher P wave dispersion was associated with LVDD in previous studies 18, 20, 35. After the multivariate analysis, our study consistently demonstrated that increased PWDC was significantly associated with increased E/Ea and LVDD.…”

Section: Discussionsupporting

confidence: 86%

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Association of Increased Arterial Stiffness and P Wave Dispersion with Left Ventricular Diastolic Dysfunction

Tsai¹,

Lee²,

Kuo³

et al. 2013

Int. J. Med. Sci.

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Background: The association between increased arterial stiffness and left ventricular diastolic dysfunction (LVDD) may be influenced by left ventricular performance. P wave dispersion is not only a significant determinant of left ventricular performance, but is also correlated with LVDD. This study is designed to compare left ventricular diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV) and corrected P wave dispersion (PWDC) and assess whether the combination of baPWV and PWDC can predict LVDD more accurately.Methods: This cross-sectional study enrolled 270 patients and classified them into four groups according to the median values of baPWV and PWDC. LVDD was defined as impaired relaxation and pseudonormal/restrictive mitral inflow patterns.Results: The ratio of transmitral E wave velocity to early diastolic mitral annulus velocity (E/Ea) was higher in group with higher baPWV and PWDC than in the other groups (all p <0.001). The prevalence of LVDD was higher in group with higher baPWV and PWDC than in the two groups with lower baPWV (p ≤ 0.001). The baPWV and PWDC were correlated with E/Ea and LVDD in multivariate analysis (p ≤ 0.030). The addition of baPWV and PWDC to a clinical mode could significantly improve the R square in prediction of E/Ea and C statistic and integrated discrimination index in prediction of LVDD (p ≤ 0.010).Conclusions: This study showed increased baPWV and PWDC were correlated with high E/Ea and LVDD. The addition of baPWV and PWDC to a clinical model improved the prediction of high E/Ea and LVDD. Screening patients by means of baPWV and PWDC might help identify the high risk group of elevated left ventricular filling pressure and LVDD.

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Section: Discussionsupporting

confidence: 86%

“…The P wave dispersion measured by 12-lead ECG was found to be associated with the occurrence of atrial fibrillation 21, 28, 32-34, left atrial enlargement and increased LAV index 16, 35. Higher P wave dispersion was associated with LVDD in previous studies 18, 20, 35.…”

Section: Discussionmentioning

confidence: 65%

Association of Increased Arterial Stiffness and P Wave Dispersion with Left Ventricular Diastolic Dysfunction

Tsai¹,

Lee²,

Kuo³

et al. 2013

Int. J. Med. Sci.

View full text Add to dashboard Cite

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“…Prolonged electromechanical delays and impaired left atrial mechanical functions were observed in RA patients and correlated with CRP level 11. P‐wave dispersion was found to be increased in RA and correlated with CRP and disease duration 12. P‐wave dispersion is considered as an electrocardiographic marker of inhomogeneous and discontinuous propagation of sinus impulses in the atrial myocardium, representing a sensitive and specific clinical predictor of AF.…”

Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation Promotion in a Rat Model of Rheumatoid Arthritis

Dai

Wang

Yin

et al. 2017

JAHA

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BackgroundThe prevalence of atrial fibrillation (AF) is significantly higher in rheumatoid arthritis (RA) patients, but the underlying mechanisms remain poorly understood. The goal of this study was to assess the effects of RA on AF susceptibility and atrial arrhythmogenic remodeling in a rat model of RA.Methods and ResultsCollagen‐induced arthritis was induced in rats by immunization with type II collagen in Freund's incomplete adjuvant. Among the rats that developed arthritis, AF susceptibility and atrial remodeling were examined 8 weeks after the primary immunization. AF inducibility and duration were substantially increased in collagen‐induced arthritis rats, and AF duration was significantly and positively correlated with the serum IL‐6 and TNF‐α levels. Rats with collagen‐induced arthritis showed prolonged atrial conduction time with no changes in the atrial effective refractory period. Atrial conduction delay was accompanied by significantly increased atrial fibrosis. In addition, atrial structural and autonomic remodeling, including left atrial dilation, apoptosis and autophagy of atrial myocytes, and atrial heterogeneous sympathetic hyperinnervation, was observed. Interestingly, we found that collagen‐induced arthritis had no significant effects on connexins, Nav1.5, and the main ion channels' protein expressions in atria.ConclusionsWe demonstrated that RA increased AF susceptibility by inducing AF‐promoting atrial remodeling. This study may provide insights into mechanisms underlying RA‐induced AF and validate a model that is suitable for further mechanistic and therapeutic exploration.

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“…Rheumatoid arthritis P-wave duration and PWD was found to be higher in rheumatoid arthritis patients than healthy control subjects [42].…”

Section: Normal Limit Values Of P-wave Dispersion (Pwd)mentioning

confidence: 99%

P-wave dispersion: an update

Pérez‐Riera

Abreu

Barbosa‐Barros

et al. 2016

Indian Pacing and Electrophysiology Journal

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P-wave dispersion (PWD, Pd or Pdis) is a noninvasive electrocardiographic (ECG) marker for atrial remodeling and predictor for atrial fibrillation (AF). PWD is defined as the difference between the widest and the narrowest P-wave duration recorded from the 12 ECG leads. Increased P-wave duration and PWD reflect prolongation of intraatrial and interatrial conduction time with lack of a well-coordinated conduction system within the atrial muscles, with inhomogeneous, asynchronic, pro-inflammatory and anti-inflammatory effect mediated by interleukin-6 (IL-6) in patients with the CG + GG genotype IL-6 -634C/G polymorphism [1] and discontinuous propagation of sinus impulses mainly between the left and right atria, interstitial/extracellular fibroblast activation and collagen deposition with fibrosis (via TGF-β) in atrial tissue, insufficient blood supply, significant not isotropic myoelectric activity, and thin wall thickness and consequent expansion tendency all well-known electrophysiological characteristics in patients with atrial arrhythmias and especially paroxysmal atrial fibrillation (PAF) [2].

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P wave dispersion in patients with rheumatoid arthritis: its relation with clinical and echocardiographic parameters

Cited by 32 publications

References 34 publications

Association of Increased Arterial Stiffness and P Wave Dispersion with Left Ventricular Diastolic Dysfunction

Association of Increased Arterial Stiffness and P Wave Dispersion with Left Ventricular Diastolic Dysfunction

Atrial Fibrillation Promotion in a Rat Model of Rheumatoid Arthritis

P-wave dispersion: an update

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