Çanga Yiğit, Emre Ayşe, Yüksel Gülbün Asuman, Karataş Mehmet Baran, Yelgeç Nizamettin Selçuk, Gürkan Ufuk, Çalık Ali Nazmi, Tireli Hülya, Terzi Sait
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
Department of Neurology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Parkinsons Dis. 2018 Jul 16;2018:2916905. doi: 10.1155/2018/2916905. eCollection 2018.
An increased risk of ischemic stroke has been reported in patients with Parkinson's disease (PD). Atrial fibrillation (AF) is strongly associated with ischemic stroke. Prolonged atrial electromechanical delay (EMD) is an independent predictor for the development of AF.
The aim of the present study was to evaluate the atrial conduction parameters in patients with PD and to assess their relation with the severity of PD.
We prospectively enrolled 51 consecutive patients with newly diagnosed PD and 31 age- and sex-matched non-PD subjects.
To assess atrial electromechanical coupling (PA), the time intervals from the onset of p wave on ECG to the late diastolic wave at the septal (PAs) and lateral (PAl) mitral annulus and lateral tricuspid annulus (PAt) were measured on Tissue Doppler Echocardiography (TDE). The difference between PAs-PAl, PAs-PAt, and PAl-PAt were defined as left intra-atrial, right intra-atrial, and interatrial EMD, respectively. P-wave dispersion (PWD) was calculated from the 12-lead ECG.
PWD, PAs, PAl, and PAt durations were significantly prolonged in the PD group (all < 0.001). Interatrial, right, and left intra-atrial EMD were also significantly longer in PD patients ( < 0.001, < 0.001 and =0.002, resp.). There were significant positive correlations between disease severity (UPDRS score) and PWD (=0.34, =0.041), left intra-atrial (=0.39, =0.005), and interatrial EMD (=0.35, =0.012). By multivariate analysis, PWD (OR: 1.13, 95% CI: 1.02-1.25; =0.017), LA volume index (OR: 1.19, 95% CI: 1.02-1.37; =0.021), left intra-atrial (OR: 1.12, 95% CI: 1.01-1.24; =0.041), and interatrial EMD (OR: 1.08, 95% CI: 1.01-1.16; =0.026) were found as independent predictors of PD.
Atrial conduction times were longer and correlated with the severity of disease in PD patients. Prolonged inter- and intra-atrial-EMD intervals were also found as independent correlates of PD. These findings may suggest an increased predisposition to atrial fibrillation in PD.
帕金森病（PD）患者缺血性卒中风险增加已见报道。心房颤动（AF）与缺血性卒中密切相关。心房电机械延迟（EMD）延长是AF发生的独立预测因素。
本研究旨在评估PD患者的心房传导参数，并评估其与PD严重程度的关系。
我们前瞻性纳入了51例新诊断的PD患者以及31例年龄和性别匹配的非PD受试者。
为评估心房电机械耦联（PA），在组织多普勒超声心动图（TDE）上测量心电图P波起始至间隔（PAs）、外侧（PAl）二尖瓣环和外侧三尖瓣环（PAt）舒张晚期波的时间间期。PAs - PAl、PAs - PAt和PAl - PAt之间的差值分别定义为左心房内、右心房内和心房间EMD。从12导联心电图计算P波离散度（PWD）。
PD组的PWD、PAs、PAl和PAt持续时间显著延长（均P < 0.001）。PD患者的心房间、右心房内和左心房内EMD也显著更长（分别为P < 0.001、P < 0.001和P = 0.002）。疾病严重程度（UPDRS评分）与PWD（r = 0.34，P = 0.041）、左心房内EMD（r = 0.39，P = 0.005）和心房间EMD（r = 0.35，P = 0.012）之间存在显著正相关。多因素分析显示，PWD（OR：1.13，95%CI：1.02 - 1.25；P = 0.017）、左心房容积指数（OR：1.19，95%CI：1.02 - 1.37；P = 0.021）、左心房内EMD（OR：1.12，95%CI：1.01 - 1.24；P = 0.041）和心房间EMD（OR：1.
