Emiroglu Mehmet Yunus, Bulut Mustafa, Sahin Müslim, Acar Gurkan, Akcakoyun Mustafa, Kargin Ramazan, Kayancicek Hidayet, Karapinar Hekim, Aung Soe Moe
Department of Cardiology, Kartal Kosuyolu Cardiovascular Research and Training Hospital, Istanbul, Turkey.
J Electrocardiol. 2011 Mar-Apr;44(2):251-6. doi: 10.1016/j.jelectrocard.2010.09.012.
We aimed to assess atrial conduction time in patients with essential hypertension.
A total of 80 patients with hypertension (51 males/29 females, 53 ± 12.5 years) and 80 controls (50 males/30 females, 50 ± 12 years) were included. Atrial electromechanical coupling (time interval from the onset of P wave on surface electrocardiogram [ECG] to the beginning of A wave interval with tissue Doppler echocardiography [PA]), intraatrial and interatrial electromechanical delay (intra and inter atrial electromechanical delay [AEMD]), and P-wave dispersion (Pd) were measured (Appelton, C.P., Hatle, L., Popp, R.L., Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol. 1988; 12: 426-440).
Atrial electromechanical coupling at the left lateral mitral annulus (PA lateral) and septal mitral annulus were longer in patients with hypertension (63.0 ± 8.0 vs 50.2 ± 4.3, P < .001, and 53.3 ± 6.2 vs 40.1 ± 5.5, P < .001). Interatrial (PA lateral-PA tricuspid) and intraatrial electromechanical delay (PA septum-PA tricuspid) were longer in patients with hypertension (24.8 ± 7.2 vs 12.4 ± 4.3, P < .001, and 14.1 ± 4.5 vs 2.3 ± 1.6, P < .001, respectively). Maximum P-wave duration and Pd were higher in patients with hypertension compared with controls (95.6 ± 8.0 vs 90.1 ± 9.5, P = .01, and 41.3 ± 7.1 vs 33.5 ± 6.1 P < .001, respectively). In correlation analysis, a positive correlation was detected between interatrial electromechanical delay and Pd (r = 0.72, P < .001). There was a moderate correlation between left ventricular mass index and PA lateral (r = 0.48, P < .001).
Our results revealed that interatrial electromechanical delay and Pd were prolonged in patients with hypertension. Our results also showed a correlation between interatrial electromechanical delay and Pd. Prolonged electromechanical delay and Pd found in hypertensive patients could be related with increased incidence of atrial fibrillation in these patients. Prospective studies are needed to document the association between intraatrial and interatrial electromechanical delays and the development of atrial fibrillation.
我们旨在评估原发性高血压患者的心房传导时间。
共纳入80例高血压患者（51例男性/29例女性，年龄53±12.5岁）和80例对照者（50例男性/30例女性，年龄50±12岁）。测量心房机电耦联（体表心电图[ECG]上P波起始至组织多普勒超声心动图[A波间期开始的时间间隔[PA]）、房内和房间机电延迟（房内和房间机电延迟[AEMD]）以及P波离散度（Pd）（Appelton, C.P., Hatle, L., Popp, R.L., 二尖瓣血流速度模式与左心室舒张功能的关系：血流动力学与多普勒超声心动图联合研究的新见解。《美国心脏病学会杂志》。1988年；12: 426 - 440）。
高血压患者二尖瓣环外侧（PA外侧）和二尖瓣环间隔处的心房机电耦联时间较长（63.0±8.0对50.2±4.3，P <.001；53.3±6.2对40.1±5.5，P <.001）。高血压患者的房间（PA外侧 - PA三尖瓣）和房内机电延迟（PA间隔 - PA三尖瓣）较长（分别为24.8±7.2对12.4±4.3，P <.001；14.1±4.5对2.3±1.6，P <.001）。与对照组相比，高血压患者的最大P波时限和Pd更高（分别为95.6±8.0对90.1±9.5，P =.01；41.3±7.1对33.5±6.1，P <.001）。在相关性分析中，检测到房间机电延迟与Pd之间呈正相关（r = 0.72，P <.001）。左心室质量指数与PA外侧之间存在中度相关性（r = 0.48，P <.001）。
我们的结果显示，高血压患者的房间机电延迟和Pd延长。我们的结果还表明房间机电延迟与Pd之间存在相关性。高血压患者中发现的机电延迟和Pd延长可能与这些患者房颤发生率增加有关。需要进行前瞻性研究来证实房内和房间机电延迟与房颤发生之间的关联。
