Three dimensional left atrial volume index is correlated with P wave dispersion in elderly patients with sinus rhythm

Özyiğit, Tolga; Kocas, Onur; Karadağ, Berrin; Özben, Beste

doi:10.1007/s00508-016-0973-1

Cited by 6 publications

(7 citation statements)

References 26 publications

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“…Elansary et al [27] reported that PWd and LAVI were the most significant independent predictors of paroxysmal atrial fibrillation in patients with non-hemorrhagic stroke. Another study that investigated the relationship between 3D left atrial volumes and PWd found that PWd was significantly correlated with 3D-LAVImin and LAVImax [28]. In the current study, cirrhotic patients had increased PWd compared to the control subjects.…”

Section: Discussionsupporting

confidence: 54%

“…In the group of cirrhosis patients, 40% (n: 20) had ascites, 20% ( n = 10) had hepatic encephalopathy, 80% ( n = 40) had esophageal varices, and 38% ( n = 19) were evaluated as having decompensated cirrhosis. The median Child–Pugh score was 6.0 [5–13], and the MELD score was 10.0 [6–29]. In terms of Child–Pugh disease classification, the patients were evaluated as follows; 57% child A, 28.5% child B and 14.5% child C. Non-selective beta-blockers were being taken by 60% of the patients, diuretics (furosemide, spironolactone) by 58%, antihypertensive drugs by 26% and insulin treatment for DM by 14%.…”

Section: Resultsmentioning

confidence: 99%

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The prognostic value of P-wave dispersion and left atrial functions assessed with three-dimensional echocardiography in patients with cirrhosis

Ozer-Sari¹,

Ünal

Çabuk

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

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Background Cirrhotic cardiomyopathy (CCM) is a well-known entity. The aim of this study was to compare left atrial three-dimensional (3D) volume and P-wave dispersion (PWd) in patients with cirrhosis and a healthy population. The secondary purpose was to assess the left phasic volumes and reservoir functions with 3D echocardiography for the prediction of an increased risk of poor outcomes in patients with cirrhosis. Methods The study included 50 patients with cirrhosis and 43 healthy control subjects without atrial fibrillation. All patients were assessed with two-dimensional (2D), 3D, and tissue Doppler transthoracic echocardiography. The PWd was calculated using a 12-lead surface electrocardiogram (ECG). Cirrhotic patients were followed up for 2.5 years for the evaluation of poor outcomes and the development of atrial fibrillation. Results Patients with cirrhosis were observed to have significantly higher left atrial phasic volumes such as minimal left atrial volume (3D-LAVmin, P = 0.004) and indexed LAVmin (3D-LAVImin, P = 0.0001), and significantly decreased left atrial reservoir functions such as left atrial emptying volume (3D-LAEV, P = 0,001), left atrial ejection fraction (3D-LAEF, P = 0,001) on 3D echocardiography. PWd was determined to be significantly longer in the cirrhotic group compared with the control group (P = 0.003). In the 2.5-year follow-up period, poor outcomes occurred in 34 patients (22 patients died, six patients had liver transplantation, six patients developed atrial fibrillation/AHRE episodes). In Cox regression analysis, the MELD score (HR, 1.16 (1.06–1.26), P = 0.001) and 3D-LAVImin (HR, 0.95 (0.86–1.00), P = 0.040) were significantly associated with all-cause mortality. Cirrhotic patients with LAVImin of >15 ml/m2 were seen to have poor survival (long rank P = 0.033). Conclusion The results of this study showed that patients with cirrhosis had higher left atrial volume, longer PWd and worse diastolic functions compared with the control group. Higher disease severity scores were associated with left atrial function and volume. In addition, left atrial volume measured with 3DE was a strong predictor of future adverse events, and minimal left atrial volumes had a higher prognostic value than any other left atrial function indices.

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Section: Discussionsupporting

confidence: 54%

Section: Resultsmentioning

confidence: 99%

The prognostic value of P-wave dispersion and left atrial functions assessed with three-dimensional echocardiography in patients with cirrhosis

Ozer-Sari¹,

Ünal

Çabuk

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

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“…This parameter index is measured by both 2-dimensional and 3-dimensional echocardiography and categorized as normal when ≤ 34 mL/m 2 or mild increased (35–41 mL/m 2 ; moderate, 42–48 mL/m 2 ; severe, ≥ 49 mL/m 2 . Consequently, PWD might be helpful in discriminating patients prone to PAF [57].…”

Section: Measurement Of P-wave Dispersionmentioning

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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“…Increased Pd has been found to be an independent predictor of PAF in patients with normal left atrial size and is proposed to occur due to changes within the atrial microarchitecture that increase the heterogeneity in sinus impulse conduction, which may occur before changes in LA dimensions [ 64 ]. Associations between left atrial size and Pd have been identified in patients with normal sinus rhythm [ 65 ] and PAF [ 64 ]. However, other studies on athletes have found no such association with atrial size [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of P Wave Indices in Healthy Standardbred Horses

White

Nath

Hebart

et al. 2023

Animals

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P wave indices are used as non-invasive electrocardiographic markers of atrial remodelling in humans. Few studies have investigated their use in animals. The aim of this study was to measure P wave duration and P wave dispersion (Pd) in healthy standardbred horses and investigate variables that might influence these measurements. A 12-lead electrocardiogram was recorded at rest and P wave indices were calculated in 53 horses. A general linear model was used to investigate the main effects: age, bodyweight, sex, resting heart rate, presence of a murmur, exercise status and the number of years raced. There were significant associations with exercise status for both the maximum P wave duration and Pd, with both values being increased in strenuously exercising versus non-active horses. Furthermore, a significant moderate positive correlation was identified between the duration of exercise (number of years raced) and both Pmax and Pd. No other significant associations were identified. These findings are similar to those reported in elite human athletes versus sedentary individuals. The increases in these P wave indices most likely occur due to prolongation and heterogeneity in atrial conduction time, which are associated with structural and electrical remodelling, and may explain the increased risk of atrial fibrillation in athletic horses.

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Three dimensional left atrial volume index is correlated with P wave dispersion in elderly patients with sinus rhythm

Abstract: In elderly patients, 3-dimensional left atrial volume index showed a better correlation with P wave dispersion and might be helpful in discriminating patients with prolonged P wave dispersion, who might be prone to atrial fibrillation.

Cited by 6 publications

References 26 publications

The prognostic value of P-wave dispersion and left atrial functions assessed with three-dimensional echocardiography in patients with cirrhosis

The prognostic value of P-wave dispersion and left atrial functions assessed with three-dimensional echocardiography in patients with cirrhosis

P-wave dispersion: an update

Assessment of P Wave Indices in Healthy Standardbred Horses

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