Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Europace. 2011 Dec;13(12):1681-7. doi: 10.1093/europace/eur261. Epub 2011 Aug 15.
The total atrial conduction time (TACT) is an important electrophysiological parameter. We developed a new transthoracic echocardiographic tool (PA-TDI). The PA-TDI interval is a reflection of the TACT. In the present study, we evaluated the clinical and echocardiographic correlates of intra-atrial conduction delay.
We studied 427 patients without class I anti-arrhythmic agents or amiodarone. All patients underwent an echocardiogram and the PA-TDI interval was measured. Patient characteristics were recorded. The mean PA-TDI was 157 ± 22 ms. Multivariate linear regression analysis revealed that atrial fibrillation (AF) in history (B = 9.7; 95%CI 5.7-13.8; P < 0.001), hypertension (B = 5.5; 95%CI 1.4-9.8; P = 0.01), clinically relevant valve disease (B = 5.7; 95%CI 0.5-10.8; P = 0.03), age (B = 5; 95%CI 3.3-6.6; P < 0.001), and body mass index (BMI; B = 2.6; 95%CI 0.3-4.9; P = 0.026) were independently associated with the PA-TDI interval. On the echocardiogram: the aortic diameter (B = 0.7; 95%CI 0.2-1.2; P = 0.009), left atrial dimension (B = 0.9; 95%CI 0.5-1.3; P < 0.001), mitral valve E-wave deceleration time (B = 0.1; 95%CI 0.1-0.1; P < 0.001), aortic incompetence (B = 13; 95%CI 3.3-22.6; P = 0.008), and mitral incompetence (B = 11; 95%CI 3.6-17.5; P < 0.003) were independently associated with the PA-TDI interval.
This study is the largest to investigate the relation between the atrial conduction time, underlying heart diseases, and echocardiographic parameters. We found that the PA-TDI was independently prolonged in patients with a history of AF, hypertension, valve disease, higher age, and a higher BMI. Signs of diastolic dysfunction, valve incompetence, and enlarged atrium or aortic root on the echocardiogram were associated with a prolonged PA-TDI. This suggests that early and aggressive treatment of hypertension, diastolic dysfunction, and obesity could prevent intra-atrial conduction delay.
总心房传导时间（TACT）是一个重要的电生理参数。我们开发了一种新的经胸超声心动图工具（PA-TDI）。PA-TDI 间期是 TACT 的反映。在本研究中，我们评估了房间内传导延迟的临床和超声心动图相关性。
我们研究了 427 名没有 I 类抗心律失常药物或胺碘酮的患者。所有患者均接受了超声心动图检查，并测量了 PA-TDI 间期。记录患者特征。平均 PA-TDI 为 157 ± 22 ms。多变量线性回归分析显示，房颤（AF）病史（B = 9.7；95%CI 5.7-13.8；P < 0.001）、高血压（B = 5.5；95%CI 1.4-9.8；P = 0.01）、临床相关瓣膜病（B = 5.7；95%CI 0.5-10.8；P = 0.03）、年龄（B = 5；95%CI 3.3-6.6；P < 0.001）和体重指数（BMI；B = 2.6；95%CI 0.3-4.9；P = 0.026）与 PA-TDI 间隔独立相关。在超声心动图上：主动脉直径（B = 0.7；95%CI 0.2-1.2；P = 0.009）、左心房内径（B = 0.9；95%CI 0.5-1.3；P < 0.001）、二尖瓣 E 波减速时间（B = 0.1；95%CI 0.1-0.1；P < 0.001）、主动脉瓣关闭不全（B = 13；95%CI 3.3-22.6；P = 0.008）和二尖瓣关闭不全（B = 11；95%CI 3.6-17.5；P < 0.003）与 PA-TDI 间隔独立相关。
这项研究是最大规模的研究，旨在探讨心房传导时间、潜在心脏病和超声心动图参数之间的关系。我们发现，房颤、高血压、瓣膜病、年龄较大和 BMI 较高的患者的 PA-TDI 明显延长。超声心动图上舒张功能障碍、瓣膜功能不全以及心房或主动脉根部增大的迹象与 PA-TDI 延长有关。这表明早期和积极治疗高血压、舒张功能障碍和肥胖症可以预防心房内传导延迟。
