Ayhan Selim, Ozturk Serkan, Alcelik Aytekin, Ozlu Mehmet Fatih, Erdem Alim, Memioglu Tolga, Ozdemir Mesut, Yazici Mehmet
Department of Cardiology, Abant Izzet Baysal University School of Medicine, Gölköy Yerleşkesi, 14280 Bolu, Turkey.
J Interv Card Electrophysiol. 2012 Dec;35(3):247-52; discussion 252. doi: 10.1007/s10840-012-9722-1. Epub 2012 Sep 26.
Prolonging atrial conduction time, as measured by tissue Doppler imaging (TDI), is an independent predictor of new onset or recurrent atrial fibrillation (AF). We investigated atrial conduction time and cardiac mechanical function in patients with impaired fasting glucose (IFG) using echocardiography.
Thirty patients with IFG (19 males and 11 females; age, 46.9 ± 9.5 years) and 30 control subjects (18 males and 12 females; age, 46.7 ± 8.2 years) were included. Atrial conduction time was determined from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septal), and lateral tricuspid annulus (PA tricuspid) by TDI. Inter- and intra-atrial electromechanical delays (EMDs) were calculated. Left atrial (LA) volumes were determined according to the biplane area-length method. LA mechanical function parameters were calculated.
LA passive emptying volume and LA passive emptying fraction decreased significantly in patients with IFG as compared with control subjects (p < 0.001 and p < 0.001, respectively). PA lateral and PA septal durations were significantly higher in patients with IFG than in the control group. However, no difference in PA tricuspid duration was observed between the two groups. Inter- and intra-atrial EMDs were significantly higher in patients with IFG as compared with the control subjects (median [interquartile range], 34.0 [17.0] vs. 17.0 [4.0], p < 0.001 and 15.0 [8.5] vs. 7.5 [2.0], p < 0.001, respectively). Positive correlations were detected between both inter- and intra-atrial EMD and glucose levels (r = 0.76, p < 0.001 and r = 0.68, p < 0.001, respectively). Additionally, a multiple linear regression analysis revealed that glucose levels were independently associated with inter-atrial EMD (β = 0.753, p < 0.001).
We showed that IFG was associated with inter- and intra-atrial EMD. Our findings suggest that IFG is an etiological factor for the development of AF.
通过组织多普勒成像（TDI）测量的心房传导时间延长是新发或复发性心房颤动（AF）的独立预测因素。我们使用超声心动图研究了空腹血糖受损（IFG）患者的心房传导时间和心脏机械功能。
纳入30例IFG患者（19例男性和11例女性；年龄46.9±9.5岁）和30例对照者（18例男性和12例女性；年龄46.7±8.2岁）。通过TDI从二尖瓣环外侧（PA外侧）、二尖瓣环间隔（PA间隔）和三尖瓣环外侧（PA三尖瓣）确定心房传导时间。计算心房内和心房间的电机械延迟（EMD）。根据双平面面积长度法测定左心房（LA）容积。计算LA机械功能参数。
与对照者相比，IFG患者的LA被动排空容积和LA被动排空分数显著降低（分别为p<0.001和p<0.001）。IFG患者的PA外侧和PA间隔持续时间显著高于对照组。然而，两组之间PA三尖瓣持续时间没有差异。与对照者相比，IFG患者的心房内和心房间EMD显著更高（中位数[四分位间距]，34.0[17.0]对17.0[4.0]，p<0.001和15.0[8.5]对7.5[2.0]，p<0.001）。在心房内和心房间EMD与血糖水平之间均检测到正相关（分别为r=0.76，p<0.001和r=0.68，p<0.001）。此外，多元线性回归分析显示血糖水平与心房间EMD独立相关（β=0.753，p<0.001）。
我们表明IFG与心房内和心房间EMD相关。我们的研究结果表明IFG是AF发生发展的一个病因学因素。
