Kurt Mustafa, Tanboğa Ibrahim Halil, Karakaş Mehmet Fatih, Büyükkaya Eyüp, Akcay Adnan Burak, Sen Nihat, Bilen Emine
Department of Cardiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey.
Turk Kardiyol Dern Ars. 2012 Dec;40(8):663-70. doi: 10.5543/tkda.2012.97404.
In this study, we aimed to investigate the association between the presence and severity of metabolic syndrome (MetS) with intra- and inter-atrial electromechanical delay (AEMD) and P-wave dispersion (PWD).
A total of 144 patients (72 MetS patients and 72 age- and sex-matched control subjects) were included in the study. Patients with MetS were classified into three groups based on the number of MetS criteria as follows: Group 1 (patients with three MetS criteria), Group 2 (patients with four MetS criteria) and Group 3 (patients with five MetS criteria). Intra- and inter-AEMD were measured from parameters of tissue Doppler imaging. PWD was calculated from the 12-lead electrocardiogram.
Both inter-AEMD (22.9±15 vs. 11.5±14, p<0.001) and intra-AEMD (23.6±12 vs. 8.3±19, p<0.001) were found to be significantly longer in patients with MetS than the control group. Similarly, PWD (49±25 vs. 36±24, p=0.001) were found to be significantly longer in the MetS patients than the controls. However, both inter-AEMD and intra-AEMD and P wave measurements were not found to be associated with the severity of MetS. While inter and intra-AEMD were better correlated with LV mass index and LA volume index, PWD correlated better with mitral inflow Doppler parameters. According to multivariate analyses, inter-AEMD, HDL-C, and systolic and diastolic blood pressure were found to be independent predictors, whereas E/A and LDL-C had borderline significance. For the intra-AEMD, systolic and diastolic blood pressure, body mass index and E/A were found to be independent predictors.
In patients with MetS, inter- and intra-AEMD, and P dispersion were found to be lengthened when compared with the controls. However, these parameters were not associated with the severity of MetS.
在本研究中,我们旨在调查代谢综合征(MetS)的存在及严重程度与心房内和心房间机电延迟(AEMD)及P波离散度(PWD)之间的关联。
本研究共纳入144例患者(72例MetS患者和72例年龄及性别匹配的对照受试者)。根据MetS标准的数量,将MetS患者分为三组:第1组(有三条MetS标准的患者)、第2组(有四条MetS标准的患者)和第3组(有五条MetS标准的患者)。通过组织多普勒成像参数测量心房内和心房间AEMD。从12导联心电图计算PWD。
发现MetS患者的心房间AEMD(22.9±15 vs. 11.5±14,p<0.001)和心房内AEMD(23.6±12 vs. 8.3±19,p<0.001)均显著长于对照组。同样,发现MetS患者的PWD(49±25 vs. 36±24,p=0.001)显著长于对照组。然而,未发现心房间和心房内AEMD及P波测量值与MetS的严重程度相关。虽然心房间和心房内AEMD与左心室质量指数和左心房容积指数的相关性更好,但PWD与二尖瓣流入多普勒参数的相关性更好。根据多变量分析,发现心房间AEMD(AEMD)、高密度脂蛋白胆固醇(HDL-C)以及收缩压和舒张压是独立预测因素,而E/A和低密度脂蛋白胆固醇(LDL-C)具有临界显著性。对于心房内AEMD,收缩压和舒张压、体重指数和E/A是独立预测因素。
与对照组相比,发现MetS患者的心房间和心房内AEMD以及P波离散度延长。然而,这些参数与MetS的严重程度无关。