The relationship between atrial electromechanical delay and left atrial mechanical function in stroke patients

Abstract

Objective:The aim of this study was to evaluate the relationship between atrial electromechanical delay (EMD) measured with tissue Doppler imaging (TDI) and left atrial (LA) mechanical functions in patients with ischemic stroke and compare them with healthy controls.Methods:Thirty patients with ischemic stroke were enrolled into this cross-sectional, observational study. The control group consisted of 35 age- and gender-matched apparently healthy individuals patients. Acute cerebral infarcts of probable embolic origin were diagnosed via imaging and were confirmed by a neurologist. Echocardiographically, time intervals from the beginning of P wave to beginning of A wave from the lateral and septal mitral and right ventricular tricuspid annuli in TDI were recorded. The differences between these intervals gave the mechanical delays (inter- and intra-atrial). Left atrial (LA) volumes were measured using the biplane area-length method, and LA mechanical function parameters were calculated. Statistical analysis was performed using student’s t-test, chi-squared test, and Pearson’s test.Results:The laboratory and clinical characteristics were similar in the two groups. Increased left atrial EMD (21.36±10.38 ms versus 11.74±6.06 ms, p<0.001), right atrial EMD (13.66±8.62 ms versus 9.66±6.81 ms, p=0.040), and interatrial EMD (35.03±9.95 ms versus 21.40±8.47 ms, p<0.001) were observed in stroke patients as compared to controls. Active LA emptying volume and fraction and passive LA emptying volumes and fraction were similar between controls and stroke patients. Total LA emptying volumes were significantly increased in stroke patients as compared to healthy controls (33.19±11.99 mL/m2 versus 27.48±7.08 mL/m2, p=0.021).Conclusion:According to the results of our study, interatrial electromechanical delay may be a new predictor for ischemic stroke.

Usefulness of Tissue Doppler-derived Atrial Electromechanical Delay for Identifying Patients with Paroxysmal Atrial Fibrillation

“…Results of ours were consistent with, and supportive of, those in these previous studies [7,8]. Among patients with prior ischemic stroke, the clinical background similar to our MRFs patients, AEMD was shown to be prolonged (not as much prolonged as in AF patients) compared with normal controls [13] Potential mechanisms of prolonged AEMD in AF Longer AEMD implies more heterogeneous propagation impulse within the atria compromised by fatty replacement [17]. Although no experimental evidence has existed on this assumption, prolonged atrial conduction time is found to be associated with increased LA diameter and reduced LA systolic function, supporting the notion that AEMD reflects structural and electrophysiological remodeling of the atrium [18][19][20].…”

“…An increased left atrial (LA) volume index is also known as a strong predictor of AF [3][4][5]. It has been reported that the intra-and interatrial conduction time, that is, the atrial electromechanical delay (AEMD), is an index of reflecting pathological changes of the atria [6][7][8][9][10][11][12][13]. AEMD can be measured not only by invasive electrophysiologic study but also by echocardiographic tissue Doppler imaging (TDI) [7][8][9][10][11][12][13].…”

Evaluation of Atrial Electromechanical Delay in Silent Cerebral Ischemia Patients

“…Diastolic functions were also assessed by DDG because they were dependent on conventional doppler load and affected by heart rate. Previous studies have shown that E/Em ratio measured from septal annuler level is significantly correlated with left ventricular end-diastolic pressure and diastolic dysfunction (24). In our study, E / Em (septal) and E/Em (lateral) values were significantly increased in the SCI group.…”

A novel biomarker for prediction of atrial fibrillation susceptibility in patients with celiac disease

“…Atrial electromechanical coupling (PA), the time interval from the onset of the P-wave on the surface electrocardiogram to the beginning of the late diastolic wave (A), was obtained from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septal), and tricuspid annulus (PA tricuspid) ( Fig 1 ). The difference between PA lateral and PA tricuspid was defined as the interatrial electromechanical delay (EMD); the difference between PA septal and PA tricuspid was defined as the intra-right atrial EMD; and the difference between PA septal and PA lateral was defined as the intra-left atrial EMD [ 24 , 25 ].…”