Department of Cardiology, Zonguldak Karaelmas University, School of Medicine, Karaelmas Universitesi Tıp Fakultesi, Kardiyoloji Bolumu, Zonguldak, Turkey.
Eur Heart J Cardiovasc Imaging. 2012 Mar;13(3):251-6. doi: 10.1093/ejechocard/jer227. Epub 2011 Nov 2.
To investigate the atrial electromechanical delay (EMD) duration that is a non-invasive predictor of atrial fibrillation (AF) in patients with Behcet's disease (BD).
Thirty-eight Behcet's patients (24 females, 14 males; mean age: 43.6 ± 10.3 years) who were being followed in the dermatology or internal medicine department and 29 demographically matched controls (13 females, 16 males; mean: age 42.6 ± 11.1 years) were included in the study. The inclusion criteria were recurrent oral ulcerations and two of the following features: recurrent genital ulceration, eye lesions, skin lesions or positive pathergy skin test for Behcet's group. Using tissue Doppler imaging, atrial electromechanical coupling [time interval from the onset of P wave on surface electrocardiogram to the beginning of A wave interval with tissue Doppler echocardiography (PA)] were measured from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum), and right ventricular tricuspid annulus (PA tricuspid). The mean disease duration was 10.5 ± 7.7 years. The inter-atrial and intra-atrial EMD were significantly higher in the Behcet group than those in the controls (19.8 ± 8.2 vs. 13.1 ± 4.4 ms, P = 0.001; 11.5 ± 7.4 vs. 6.9 ± 3.7 ms, P = 0.02; respectively). The left atrial EMD was similar in both of the groups. However, the P(max) and PWD values were significantly higher in the BD group compared with those in the controls (120.5 ± 10.1 vs. 112.1 ± 5.9 ms, P < 0.0001; 44.9 ± 10.7 vs. 28.4 ± 5.9 ms, P < 0.0001; respectively).
Atrial electromechanical conduction times were increased in the BD patients compared with those in the controls. The tendency of BD patients to go into AF can be easily and non-invasively detected using tissue Doppler echocardiography. These findings may be indicators for subclinical cardiac involvement.
研究非侵入性预测心房颤动（房颤）的电机械延迟（EMD）持续时间在白塞病（BD）患者中的作用。
38 例白塞病患者（24 名女性，14 名男性；平均年龄：43.6 ± 10.3 岁）和 29 名年龄匹配的对照组（13 名女性，16 名男性；平均年龄：42.6 ± 11.1 岁）被纳入研究。纳入标准为复发性口腔溃疡和以下两项特征中的两项：复发性生殖器溃疡、眼部病变、皮肤病变或白塞病组的帕特肌皮肤试验阳性。使用组织多普勒成像，从外侧二尖瓣环（PA 外侧）、间隔二尖瓣环（PA 间隔）和右心室三尖瓣环（PA 三尖瓣）测量心房电机械偶联[体表心电图 P 波起始到组织多普勒超声心动图 A 波起始的时间间隔（PA）]。平均疾病持续时间为 10.5 ± 7.7 年。白塞病组的房间隔和房间内 EMD 明显高于对照组（19.8 ± 8.2 对 13.1 ± 4.4 ms，P = 0.001；11.5 ± 7.4 对 6.9 ± 3.7 ms，P = 0.02）。两组的左房 EMD 相似。然而，BD 组的 P(max)和 PWD 值明显高于对照组（120.5 ± 10.1 对 112.1 ± 5.9 ms，P < 0.0001；44.9 ± 10.7 对 28.4 ± 5.9 ms，P < 0.0001）。
与对照组相比，BD 患者的心房电机械传导时间增加。使用组织多普勒超声心动图可以轻松、非侵入性地检测 BD 患者发生房颤的倾向。这些发现可能是亚临床心脏受累的指标。
