Acar Gurkan, Sayarlioglu Mehmet, Akcay Ahmet, Sokmen Abdullah, Sokmen Gulizar, Altun Burak, Nacar Alper Bugra, Gunduz Mehmet, Tuncer Cemal
Department of Cardiology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey.
Echocardiography. 2009 May;26(5):549-57. doi: 10.1111/j.1540-8175.2008.00838.x.
The aim of this study was to evaluate atrial conduction abnormalities obtained by Doppler tissue imaging (DTI) and electrocardiogram analysis in ankylosing spondylitis (AS) patients.
A total of 40 patients with AS (22 males /18 females, 37.82 +/- 10.22 years), and 42 controls (22 males/20 females, 35.74 +/- 9.98 years) were included. Systolic and diastolic left ventricular (LV) functions were measured by using conventional echocardiography and DTI. Interatrial and intraatrial electromechanical coupling (PA) intervals were measured with DTI. P-wave dispersion (PD) was calculated from the 12-lead electrocardiogram.
Atrial electromechanical coupling at the left lateral mitral annulus (PA lateral) was significantly delayed in AS patients (61.65 +/- 7.81 vs 53.69 +/- 6.75 ms, P < 0.0001). Interatrial (PA lateral - PA tricuspid), intraatrial electromechanical coupling intervals (PA septum - PA tricuspid), maximum P-wave (Pmax) duration, and PD were significantly longer in AS patients (23.50 +/- 7.08 vs 14.76 +/- 5.69 ms, P < 0.0001; 5.08 +/- 5.24 vs 2.12 +/- 2.09 ms, P = 0.001; 103.85 +/- 6.10 vs 97.52 +/- 6.79 ms, P < 0.0001; and 48.65 +/- 6.17 vs 40.98 +/- 5.37 ms, P < 0.0001, respectively). Reflecting LV diastolic function mitral A-wave and E/A, mitral E-wave deceleration time (DT), Am and Em/Am were significantly different between the groups (P < 0.05). We found a significant correlation between interatrial electromechanical coupling interval with PD (r = 0.536, P < 0.01). Interatrial electromechanical coupling interval was positively correlated with DT (r = 0.422, P < 0.01) and inversely correlated with E/A (r =-0.263, P < 0.05) and Em/Am (r =-0.263, P < 0.05).
This study shows that atrial electromechanical coupling intervals and PD are delayed, and LV diastolic functions are impaired in AS patients.
本研究旨在评估强直性脊柱炎（AS）患者经多普勒组织成像（DTI）和心电图分析获得的心房传导异常情况。
共纳入40例AS患者（男22例/女18例，年龄37.82±10.22岁）和42例对照者（男22例/女20例，年龄35.74±9.98岁）。采用传统超声心动图和DTI测量左心室（LV）的收缩和舒张功能。用DTI测量房间和房内机电耦合（PA）间期。从12导联心电图计算P波离散度（PD）。
AS患者二尖瓣环外侧的心房机电耦合（PA外侧）明显延迟（61.65±7.81 vs 53.69±6.75毫秒，P<0.0001）。AS患者的房间（PA外侧 - PA三尖瓣）、房内机电耦合间期（PA间隔 - PA三尖瓣）、最大P波（Pmax）时限和PD明显更长（23.50±7.08 vs 14.76±5.69毫秒，P<0.0001；5.08±5.24 vs 2.12±2.09毫秒，P = 0.001；103.85±6.10 vs 97.52±6.79毫秒，P<0.0001；以及48.65±6.17 vs 40.98±5.37毫秒，P<0.0001）。反映LV舒张功能的二尖瓣A波和E/A、二尖瓣E波减速时间（DT）、Am和Em/Am在两组间有显著差异（P<0.05）。我们发现房间机电耦合间期与PD之间存在显著相关性（r = 0.536，P<0.01）。房间机电耦合间期与DT呈正相关（r = 0.422，P<0.01），与E/A呈负相关（r = -0.263，P<0.05），与Em/Am呈负相关（r = -0.263，P<0.05）。
本研究表明，AS患者的心房机电耦合间期和PD延迟，且LV舒张功能受损。
