Wave Dispersion In Patients Research Articles

Study of P wave dispersion in patients with paroxysmal atrial fibrillation and its role in prediction of atrial fibrillation recurrence

BackgroundIt has been known that increased P wave duration and P wave dispersion reflect prolongation of intra-atrial and interatrial conduction time and the inhomogeneous propagation of sinus impulses, which are well-known electrophysiologic characteristics in patients with atrial arrhythmias and especially paroxysmal atrial fibrillation. The objective of this study was assessment of P wave dispersion value in cases with paroxysmal atrial fibrillation and its role in predicting recurrence.ResultsForty-eight patients with documented paroxysmal AF were subjected to clinical evaluation, electrocardiogram and routine Doppler echocardiogram. We found that a statistically significant association was detected between P wave dispersion and older age, diabetic and hypertensive cases with positive correlation also detected with left atrial dimension (LAD), left ventricle size and diastolic dysfunction grade. Mean corrected P wave dispersion and corrected QT interval were higher among cases using sotalol, ca channel blockers, among cases using nitrates and among cases with Morris index > 0.04. Higher mean value of corrected QT was associated with biphasic P v1 shape. Old age, female sex, P wave dispersion and QT wave dispersion are statistically significant predictors of PAF recurrence.ConclusionP wave dispersion in patients with paroxysmal atrial fibrillation was strongly correlated to older age, diabetic and hypertensive patients and also with left atrial dimension (LAD), left ventricle size and diastolic dysfunction grade. Also, mean corrected P wave dispersion can predict atrial fibrillation recurrence in patients with Morris index > 0.04, old age, female sex, and QT wave dispersion.

Experience in the use of dispersion and shear waves in patients after liver transplantation

The article presents the experience of using liver elastometry and shear wave dispersion in patients after transplantation, followed by needle biopsy and morphological examination of the organ tissue. The paper shows that the use of elastometry and shear wave dispersion allows one to fairly accurately judge the state of the liver transplant parenchyma and choose the optimal strategy for treatment and management of the patient without performing an invasive procedure — puncture biopsy of the organ.

Assessment of atrial electromechanical interval and P wave dispersion in patients with polycystic ovary syndrome

Assessment of atrial electromechanical interval and P wave dispersion in patients with polycystic ovary syndrome

Short Term Effect of Percutaneous Mitral Commissurotomy on P Wave Dispersion in Patients with Mitral Stenosis

Short Term Effect of Percutaneous Mitral Commissurotomy on P Wave Dispersion in Patients with Mitral Stenosis

Assessment of P Wave Peak Time and P Wave Dispersion in Patients with COVID-19 Infection

Assessment of P Wave Peak Time and P Wave Dispersion in Patients with COVID-19 Infection

Relationship between left atrial scar and P wave dispersion in patients undergoing atrial fibrillation catheter ablation

Background Left atrial scar is an important entity in the atrial fibrillation substrate. P wave dispersion (PWD) is an indicator of slow and inhomogeneous conduction in the atria. In this study, we aim to investigate the relation between PWD and left atrial scars identified by electroanatomical mapping. Methods Patients who had an electroanatomical map obtained during sinus rhythm as well as at least one electrocardiogram in sinus rhythm prior to the procedure were included in the study. Left atrial scar (defined as <0.5 mV) area was calculated on the electroanatomical map. Maximum and minimum P wave duration and PWD were compared between patients with and without left atrial scar. Results A total of 224 patients were enrolled in the study. Of them, 47.9% of the patients were female. On the electroanatomical map, left atrial scar was identified in 103 patients, and no scar was present in 121 patients. PWD was significantly increased in patients with left atrial scar when compared to the no-scar group (46 ms ± 20 vs. 38 ms ± 15, respectively, p < 0.001). Similarly, PWD was significantly increased in patients with moderate-to-severe scar, when compared to patients with mild scar (50 ms ± 19 vs. 41 ms ± 19, respectively, p = 0.026). PWD was found not to be a good predictor of left atrial scar with an AUC of 0.625 for scar vs. no scar. Conclusion PWD is significantly increased in patients with left atrial scar identified by electroanatomical mapping, however, the receiver operating characteristic analysis showed that PWD is not a good predictor of presence of left atrial scar.

QT Wave Dispersion in Patients With Major Depressive Disorder.

A limited number of studies have investigated QT wave dispersion (QTd) in depressive disorder. The objective of this study was to investigate whether QTd differed in patients diagnosed with depression compared to a control group and whether the difference correlated with the depression and anxiety scores. Forty patients diagnosed with major depressive disorder (DSM-5 criteria) who did not receive their first treatment after the first episode were included in the study. Forty healthy individuals with similar sociodemographic characteristics were included in the control group. A sociodemographic and clinical data form, the Beck Depression Inventory, and the Beck Anxiety Inventory were given to all patients. Electrocardiograms were evaluated in a single-blind setting by the same cardiologist. The longest QT interval (QTmax) and the shortest QT interval (QTmin) were calculated. Heart rate-corrected QTmax (QTcmax) and QTmin (QTcmin) were calculated using the Bazett formula (QT[ms]/√R-R). The difference between QTcmax and QTcmin was accepted as the corrected QT dispersion (QTcd). The study was conducted from December 2018-March 2019. No statistically significant difference was found between patient and control groups on the basis of age, sex, body mass index, or smoking. Beck Anxiety Inventory and Beck Depression Inventory scores of the patient group (28.48 ± 12.39 and 32.2 ± 11.58, respectively) were significantly higher compared to the control group (2.7 ± 3.41 and 2.75 ± 3.2, respectively). The patient group QTcmax (419.8 ± 24.46) and QTcd (42.55 ± 17.47) values were significantly higher compared to the QTcmax (405.2 ± 24.54) and QTcd (30.48 ± 9.25) values of the control group. There was a positive correlation between QTcd, QTcmax, and anxiety and depression scores. QTcd values of depressed patients were higher than those of the healthy controls, and there was a positive correlation between QTcd and depression and anxiety scores.

P wave dispersion in patients with premenstrual dysphoric disorder

P wave dispersion in patients with premenstrual dysphoric disorder

P wave dispersion in patients with erectile dysfunction.

Background and aimsP wave dispersion (PWD) has been reported to be a non-invasive electrocardiographic predictor for atrial fibrillation. The aim of this study is to evaluate PWD between men with erectile dysfunction (ED) and healthy controls in order to investigate whether PWD was prolonged in patients with ED and related to severity of the disease.MethodsThis study included a total of 72 men (42 patients with ED and 30 healthy controls). Demographic data and clinical features were recorded on admission. An electrocardiographic evaluation was obtained to measure PWD values for both patients and controls.ResultsMaximum P wave duration was 108.5 ± 4.7 and 108.3 ± 4.3 in ED group and control group, respectively (p = 0.748). Minumum P wave duration was significantly higher in the control group than in the ED group. PWD was 48.1 ± 5.9 in the ED group. As a result, PWD was prolonged in patients with ED (48.1 ± 5.9 vs. 38.0 ± 3.9, p < 0.05). A significant negative correlation was observed between IIEF score and PWD values (p < 0.05, r = −0.662).ConclusionsPatients with ED exhibited prolonged PWD values compared with normal controls. In addition, PWD was found to be associated with severity of the disease.

Assessment of atrial electromechanical delay and P wave dispersion in patients with chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is associated with atrial fibrillation (AF) and reduced forced expiratory volume (FEV1) is an independent predictor for new onset AF. The aims of this study were (1) to analyze the atrial electromechanical delay (AEMD) and P wave dispersion which are two predictors of AF development in patients with COPD and without any cardiovascular disease, and (2) to assess the relationship of those with pulmonary functions as quantified by FEV1 measurements. The study included 41 patients with COPD (33 male; mean age: 51 years) and 32 healthy controls. P wave dispersion was calculated as the difference between the maximum and minimum P wave duration in a 12-lead surface electrocardiography (ECG) recording. AEMD, defined as the time interval from the P wave onset on the ECG to the initiation of the late diastolic (Am) wave using a tissue Doppler examination, was measured from the lateral mitral annulus (LAEMD), septal annulus (SAEMD), and tricuspid lateral annulus (TAEMD). P wave dispersion was significantly longer in the COPD group than those in the controls (76±19 ms vs. 45±10 ms; p<0.001). All of the AEMD measurements demonstrated significant prolongation in patients with COPD (LAEMD: 74±9 ms vs. 64±11 ms; SAEMD: 66±10 ms vs. 57±12 ms; and TAEMD: 65±9 ms vs. 46±7 ms; p<0.001 for all). The only correlation with FEV1 was observed in the TAEMD values of the COPD group (rs: -401; p<0.009). Both P wave dispersion and AEMD parameters were significantly longer in COPD patients without any established structural or functional cardiac abnormalities, indicating an increased tendency for AF development, beginning from the initial stages of the disease.

Prediction of Reperfusion and Infarct Related Artery Patency after Thrombolysis in Acute Anterior Myocardial Infarction by Degree of P Wave Dispersion on ECG

Background: Early detection IRA patency following thrombolytic therapy is of great importance in terms of prognosis and identification of candidates for rescue percutaneous coronary intervention (PCI). P wave dispersion (PWD), a new parameter measured before and after thrombolytic therapy is supposed to predict successful reperfusion in patients with anterior acute myocardial infarction (AMI).Methods: 132 patients were selected and divided into two groups on the basis of ST Segment resolution (STR) after 120 minutes of thrombolysis. Group I: patients with STR &gt;70%; Group II: patients with STR &lt; 70%. P wave dispersion was measured in both groups before and after thrombolysis. All patients underwent coronary angiography (CAG). IRA was considered patent if TIMI flow grade was e”2.Results: It was observed that diabetes mellitus and dyslipidemia were significantly higher in group II patients (p=0.04 and p=0.03, respectively). PWD before thrombolysis (PWD0) and 90 minutes after thrombolysis (PWD90) in both groups were statistically insignificant (p=0.45 and p=0.19, respectively). The mean level of PWD120 was statistically significant (p=0.001). After multivariate regression analysis PWD120 was found to be the significant predictor of IRA patency (OR = 1.101; 95% CI = 1.012 – 1.240; p = 0.01).Conclusion: P wave dispersion in patients receiving thrombolytic therapy can be a predictor of successful reperfusion and patent IRA. PWD values, in combination with other reperfusion parameters, can contribute to the identification of rescue PCI candidates.Cardiovasc. j. 2018; 10(2): 158-163

P1038Evaluation of atrial conduction time in relation to p wave dispersion in patients with different degree of hypertension arterialis with no history of paroxysmal atrial fibrillation

P1038Evaluation of atrial conduction time in relation to p wave dispersion in patients with different degree of hypertension arterialis with no history of paroxysmal atrial fibrillation

QT dispersion and P wave dispersion in patients with fibromyalgia.

Fibromyalgia (FM) is a chronic disease characterized by widespread pain. Somatic complaints associated with the cardiovascular system, such as chest pain and palpitations, are frequently seen in FM patients. P and QT dispersions are simple and inexpensive measurements reflecting the regional heterogeneity of atrial and ventricular repolarization, respectively. QT dispersion can cause serious ventricular arrhythmias. The aim of the present study was to evaluate QT dispersion and P wave dispersion in patients with FM. The study involved 48 FM patients who fulfilled the established criteria and 32 healthy controls (HC). A standard 12-lead electrocardiogram was performed on all participants. QT dispersion was defined as the difference between the longest and the shortest QT intervals. Similarly, the differences between the shortest and longest P waves were defined as P wave dispersion. The QT dispersion and corrected QT dispersion were shorter in the FM group compared with the HC group (p<0.001 for both). In terms of the P wave dispersion value, there was no significant difference between the FM and HC groups (p=0.088). Longer QT and P wave dispersions are not problems in patients with FM. Therefore, it may be concluded that fibromyalgia does not include an increased risk of atrial and/or ventricular arrhythmias.

Assessment of atrial electromechanical interval and P wave dispersion in patients with polycystic ovary syndrome.

Objective:Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risk, including ischemic stroke. Prolonged atrial electromechanical interval (EMI) is related to increased atrial fibrillation (AF) risk. The aim of the study is to evaluate atrial EMI and electrocardiographic P-wave indices related to increased AF risk in patients with PCOS.Methods:Forty PCOS patients diagnosed on the basis of the Rotterdam criteria and 20 age-matched controls were prospectively included. patients with atrioventricular or intraventricular conduction abnormalities, dysrhythmia or taking antiarrhythmic drugs, atherosclerotic heart disease, cardiomyopathies, valvular lesions, pericardial disease, a history of pulmonary emboli or pulmonary hypertension, and abnormal thyroid function were excluded. Intra and interatrial EMI were measured by tissue Doppler imaging and P-wave dispersion (Pd) was calculated on 12-lead electrocardiography (ECG). The Isovolumetric relaxation time was the interval between the aortic valve closure artifact at the end of the LV outflow envelope and the mitral valve opening artifact at the beginning of the mitral E wave.Results:Patients with PCOS had significantly higher interatrial [38 (24-65) ms vs. 16 (9-19) ms p<0.001], left-sided intra-atrial (14.8±6.1 vs. 7±1.7 ms, p<0.001), and right-sided intra-atrial (22.3±8.1 vs. 8.6±3.6 ms, p<0.001) EMI compared with the control group. Pd was significantly greater in the PCOS group compared with control group [45 (27-60) ms vs. 30 (26–38) ms, p<0.001]. Echocardiographic parameters of atrial EMI were significantly correlated with body mass index, Pd, and isovolumetric relaxation time in patients with PCOS.Conclusion:PCOS is associated with prolonged inter- and intra-atrial conduction times, which are related to increased AF risk.

PP-104 Sertraline and P Wave Dispersion in Patients with Depression

PP-104 Sertraline and P Wave Dispersion in Patients with Depression

OP-034 The Relationship Between the Degree of Collateral Circulation and Atrial Electromechanical Delay and P Wave Dispersion in Patients with Coronary Collateral Circulation

Coronary collateral circulation (CCC) consists of vascular channels which are activated to maintain perfusion in major epicardial coronary arteries in the development of severe stenosis. The presence of well developed CCC may prevent myocardium from ischemic damage and may improve the prognosis of coronary artery disease. It is known that myocardial ischemia may cause cardiac electrical instability. In this study, it was aimed to assess P wave dispertion (PWD), minimum and maximum P wave duration, intra-atrial and inter-atrial electromechanic delay (AEMD); which are predictors of atrial fibrilation in patients with CCC and evaluate the relation between these parameters and Rentrop classification which shows the degree of collateral development.

Left Atrial Mechanical Functions, Atrial Electromechanical Delay and P Wave Dispersion in Patients with Mild to Moderate Psoriasis

bACkgrOunD: Many systemic diseases, including cardiovascular disturbances, have been described in patients with psoriasis. In previous studies, left ventricular (LV) subclinical myocardial dysfunction has been reported in psoriatic patients. ObjECTivE: To evaluate the effect of psoriasis on left atrial (LA) functions, which is an important determinant in left ventricular filling, atrial electromechanical coupling and P wave dispersion, in patients with mild to moderate psoriasis. METHODS: Thirty patients with psoriasis (mean [± SD] age 39±13 years) and 30 controls (mean age 34±8 years) were enrolled. Psoriatic disease severity was evaluated by the Psoriasis Area and Severity Index. LA volumes were measured using the biplane area-length method, and LA mechanical function parameters were calculated using echocardiography. Atrial electromechanical delays were measured by tissue Doppler imaging. P wave dispersion was calculated using 12-lead electrocardiograms. rESuLTS: There were no significant differences between the groups for LA mechanical function indices. No difference was detected between the groups with regard to interatrial electromechanical delay (PA lat –PA tricus ) and intra-atrial electromechanical delay (PA sep –PA tricus ) (14.4±5.7 ms versus 12.5±4.2 ms; P>0.05 and 6.3±3.5 ms versus 5.1±3.4 ms; P>0.05, respectively). There were no differences between groups with regard to P wave dispersion. COnCLuSiOnS: The present study showed that LA mechanical functions were not impaired in patients with mild to moderate psoriasis. Interatrial electromechanical delays were not changed in the psoriasis group. In addition to this, P wave dispersion was not different between two groups.

QT wave dispersion in patients with panic disorder

QT dispersion (QTd), defined as the maximal inter-lead difference in QT intervals on 12 leads of the surface electrocardiogram (ECG), reflects the regional heterogeneity of ventricular repolarization and has been suggested as an important marker for risk of arrhythmia in addition to the QT interval. Some investigators proposed that it might be a predisposing factor for arrhythmic events and sudden death. Thus, we aimed to investigate whether QTd differs in patients with panic disorder from that in healthy controls. In 40 panic disorder patients and 40 healthy controls, Q(max), Q(min), and QTd values were measured. In addition, the Hamilton depression rating scale and the panic agoraphobia scale were scored for both patients and healthy volunteers. Q(max) and Q(min) values in the panic disorder patients were significantly higher than those in healthy controls. The mean corrected QTd was significantly greater in the patients than in the controls. One-way analysis of covariance (ANCOVA; using left atrial size, age and heart rate as covariates) also corrected the significant difference. In addition, ANCOVA revealed a significant main effect for the diagnosis, indicating a significantly higher QTd for patients compared with controls. QTd might be associated with panic disorder. Future studies in larger samples evaluating the effects of treatment are required.

The effect of the glucose-insulin-potassium solution on the p-wave dispersion of the heart failure patients

Atrial fibrillation (AF) has adverse effects on the disease prognosis and the functional capacity during heart failure. P wave dispersion has been considered as one of the most important parameters predicting the development of AF. It is known that glucose-insulinpotassium (GIK) infusion has favorable metabolic and hemodynamic effects. The aim of our study is to investigate the effects of GIK infusion on P wave dispersion in patients with heart failure. In our study, 30 patients with the diagnosis of heart failure and a low left ventricular ejection fraction (EF0.05). In Group I, P wave dispersion measured after GIK infusion was 13 ± 6.5. In group II, P wave dispersion measured after 0.9% NaCl solution infusion were 20.4±6.4. P wave dispersion was found significantly lower in patients administrated GIK infusion (p=0.001). According to the present study, we showed that the P wave dispersion which predicts AF was significantly lower in the patients treated with GIK than in the control group.

Homocysteine and P wave dispersion in patients with heart transplantation

Hyperhomocysteinemia (HHcy), a putative independent risk factor for the development of atherotrombosis in the general population, represents a very common finding in orthotopic heart transplantation (OHT) patients. Starting from previous studies suggesting a pro-arrhythmogenic activity of homocysteine (Hcy), we evaluated the possible correlation among Hcy plasma levels and P wave dispersion (PWD), corrected QT interval (QTc), and QTc dispersion (QTcD) as parameters of electric instability of the myocardium in patients undergone OHT whose hearts are therefore completely denervated, thus unresponsive to autonomic influences. Homocysteine plasma levels, PWD, QTc, QTcD, and QTc dynamics were measured in 32 patients, who underwent OHT, and in 20 control subjects. In OHT patients, PWD (39.5 ± 11 vs. 34 ± 6 ms, p = 0.04) and QTc interval (438 ± 20 vs. 410 ± 10 ms, p < 0.001) were significantly higher in comparison with control subjects. Moreover, OHT subjects with HHcy had higher PWD values than those with normal Hcy plasma levels (44.1 ± 10.7 vs. 33.9 ± 8.8 ms, p = 0.007), but no difference was found between this latter OHT group and controls. Accordingly, in OHT patients, plasma Hcy level correlated significantly with PWD (Spearman r = 0.70; p < 0.0001), whereas no correlation was found with QTc, QTcD, and QTc circadian dynamics. HHcy seems associated with an alteration in the electrical atrial conduction, possibly contributing, at least in part, to the increased risk of cardiac arrhythmias in the denervated hearts of OHT patients.