Assessment of Atrial Conduction Times in Patients with Newly Diagnosed Parkinson's Disease.

Yiğit Çanga,Ali Nazmi Çalık,Ayşe Emre,Nizamettin Selçuk Yelgeç,Mehmet Baran Karataş,Gülbün Asuman Yüksel,Ufuk Gürkan,Sait Terzi,Hülya Tireli

doi:10.1155/2018/2916905

Abstract

Background An increased risk of ischemic stroke has been reported in patients with Parkinson's disease (PD). Atrial fibrillation (AF) is strongly associated with ischemic stroke. Prolonged atrial electromechanical delay (EMD) is an independent predictor for the development of AF. Aims The aim of the present study was to evaluate the atrial conduction parameters in patients with PD and to assess their relation with the severity of PD. Study design We prospectively enrolled 51 consecutive patients with newly diagnosed PD and 31 age- and sex-matched non-PD subjects. Methods To assess atrial electromechanical coupling (PA), the time intervals from the onset of p wave on ECG to the late diastolic wave at the septal (PAs) and lateral (PAl) mitral annulus and lateral tricuspid annulus (PAt) were measured on Tissue Doppler Echocardiography (TDE). The difference between PAs-PAl, PAs-PAt, and PAl-PAt were defined as left intra-atrial, right intra-atrial, and interatrial EMD, respectively. P-wave dispersion (PWD) was calculated from the 12-lead ECG. Results PWD, PAs, PAl, and PAt durations were significantly prolonged in the PD group (all p < 0.001). Interatrial, right, and left intra-atrial EMD were also significantly longer in PD patients (p < 0.001, p < 0.001 and p=0.002, resp.). There were significant positive correlations between disease severity (UPDRS score) and PWD (r=0.34, p=0.041), left intra-atrial (r=0.39, p=0.005), and interatrial EMD (r=0.35, p=0.012). By multivariate analysis, PWD (OR: 1.13, 95% CI: 1.02–1.25; p=0.017), LA volume index (OR: 1.19, 95% CI: 1.02–1.37; p=0.021), left intra-atrial (OR: 1.12, 95% CI: 1.01–1.24; p=0.041), and interatrial EMD (OR: 1.08, 95% CI: 1.01–1.16; p=0.026) were found as independent predictors of PD. Conclusion Atrial conduction times were longer and correlated with the severity of disease in PD patients. Prolonged inter- and intra-atrial-EMD intervals were also found as independent correlates of PD. These findings may suggest an increased predisposition to atrial fibrillation in PD.

Highlights

Parkinson’s disease (PD) has been associated with an increased risk of ischemic stroke and stroke-related mortality [1,2,3]
P-wave dispersion (PWD) (OR: 1.13, 95% CI: 1.02–1.25; p 0.017), LA volume index (OR: 1.19, 95% CI: 1.02–1.37; p 0.021), left intra-atrial (OR: 1.12, 95% CI: 1.01–1.24; p 0.041), and interatrial electromechanical delay (EMD) (OR: 1.08, 95% CI: 1.01–1.16; p 0.026) were found to be independent predictors of PD (Table 3)
Discussion e major findings of the present study are (1) patients with newly diagnosed PD are more likely to have abnormal atrial conduction times as assessed by prolonged PWD, PAs, PAl, PAt, intra-atrial, and interatrial EMD; (2) prolonged atrial conduction times were significantly correlated with the severity of PD as assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS) score, and (3) PWD, left intra-atrial, and interatrial EMD were found to be independent predictors of PD

Summary

Introduction

Parkinson’s disease (PD) has been associated with an increased risk of ischemic stroke and stroke-related mortality [1,2,3]. Ere were significant positive correlations between disease severity (UPDRS score) and PWD (r 0.36, p 0.008), left intra-atrial (r 0.34, p 0.015), and interatrial EMD (r 0.43, p 0.002) (Figure 1).

Results

Conclusion