Prolonged P wave dispersion in pre-diabetic patients

Background: It is known that overt diabetes as well as chronic hyperglycaemia can lead to atrial fibrillation. A P wave dispersion (PWD) represents heterogeneity in atrial refractoriness

The Value of P wave dispersion in predicting reperfusion and infarct related artery patency in acute anterior myocardial infarction

Purpose: The aim of this study is to investigate whether P wave dispersion (PWD), measured before, during and after fibrinolytic therapy (FT,) is able to predict successful reperfusion and infarct related artery (IRA) patency in patients with acute anterior MI who received FT

The Value of P wave dispersion in predicting reperfusion and infarct related artery patency in acute anterior myocardial infarction

Purpose: The aim of this study is to investigate whether P wave dispersion (PWD), measured before, during and after fibrinolytic therapy (FT,) is able to predict successful reperfusion and infarct related artery (IRA) patency in patients with acute anterior MI who received FT. Methods: Sixty-eight patients who presented with acute anterior MI were enrolled in the study. An electrocardiogram was performed before and at 30, 60, 90 and 120 minutes after the start of FT. PWD was defined as the difference between maximum and minimum P wave duration on standard 12-lead surface electrocardiogram. A multivariate logistic regression model was used to assess whether PWD was predictor of IRA patency and ST-segment resolution (STR) on electrocardiogram. Results: PWD120 was significantly lower in patients with STR on electrocardiogram (38 patients) compared with those without STR (30 patients) (44.8±11.5 vs. 52.9±10.3 ms; p < 0.001). PWD120 was found to be significantly lower in patients with patent IRA (31 patients) compared to those with occluded IRA (37 patients) (42.3±9.7 vs. 53.5±10.6 ms; p < 0.001). Logistic regression analysis revealed that PWD120 significantly predicted STR and IRA patency. A ≥51.6 ms PWD120 can predict an occluded IRA with a 87% sensitivity, ≥51 ms PWD120 can predict no reperfusion with a 74% sensitivity. Conclusion: PWD values, which were higher than 51 ms and 51.6 ms in patients who received fibrinolytic therapy, can serve as a marker of failed reperfusion and occluded IRA. PWD values, in combination with other reperfusion parameters, can contribute to the identification of rescue PCI candidates

Influence of Menstrual Cycle on P Wave Dispersion

Female gender is an independent risk factor for some types of arrhythmias. We sought to determine whether the menstrual cycle affects P wave dispersion, which is a predictor of atrial fibrillation. The study population consisted of 59 women in follicular phase (mean age, 29.3 +/- 7.7 years) (group F) and 53 women in luteal phase (mean age, 28.1 +/- 6.8 years) (group L). The ECGs of 35 patients (mean age, 26.4 +/- 4.5) were obtained in both follicular and luteal phase. Both groups underwent a standard 12-lead surface electrocardiogram recorded at 50 mm/s. Maximal (Pmax) and minimal P wave durations (Pmin) were measured. P wave dispersion (PD) was defined as the difference between Pmax and Pmin. PD was significantly higher in group L than group F (46.6 +/- 18.5 versus 40.1 +/- 12.7; P < 0.05). Pmin was significantly lower in group L than group F (51.6 +/- 12.1 versus 59.1 +/- 12.1; P = 0.002). When we compared ECGs in different phases of the 35 patients, PD was significantly higher in luteal phase than follicular phase (53.2 +/- 12.3 versus 42.8 +/- 10.2; P < 0.05). Pmin was significantly lower in luteal phase than follicular phase (47.6 +/- 6.6 versus 56 +/- 10.1; P = 0.05). We detected a significant correlation between the day of the menses and PD (r = 0.27; P < 0.05). PD was increased in luteal phase compared to follicular phase, and this difference was more prominent as the days of the cycle progressed. (Int Heart J 2011; 52: 23-26

Wydłużona dyspersja załamka P u chorych ze stanem przedcukrzycowym

Background: It is known that overt diabetes as well as chronic hyperglycaemia can lead to atrial fibrillation. A P wave dispersion (PWD) represents heterogeneity in atrial refractoriness. Aim: To investigate PWDs in patients with pre-diabetes. Method: Based on the results of examinations, 84 pre-diabetic patients (the pre-DM group; 50 female, 34 male; mean age 54 &#177; 8.6 years) who had no overt diabetes, coronary artery disease or hypertension, whose fasting blood glucose was higher than 100 mg/dL and/or whose 2 h glucose concentrations on an oral glucose tolerance test was in the range of 140 to 199 mg/dL, and 48 healthy volunteers (the non-DM group, 30 female, 18 male; mean age 51.7 &#177; 7.3 years) with no illnesses, were enrolled in this study. Standard 12-lead electrocardiograms of all patients were taken at 50 mm/s and 20 mm/mV standardisation. Maximum (Pmax) and minimum (Pmin) P-wave durations were measured. The PWD was defined as the difference between Pmax and Pmin. Results: The Pmax and PWD values were significantly higher in pre-DM compared to non-DM (104 &#177; 13 ms vs 98 &#177; 12 ms; p < 0.05, 42 &#177; 13 ms vs 34 &#177; 11 ms; p < 0.01 respectively). A positive correlation was found between PWD and fasting blood glucose (r = 0.32; p 0.05). Multivariate regression analysis showed no relationship between PWD and age, left atrial diameter, E, A, E/A or HbA1c. However, there was a relationship between PWD and fasting blood glucose. Conclusions: The Pmax and PWD are increased in pre-diabetic patients who have no coronary artery disease, hypertension or left ventricular hypertrophy. Kardiol Pol 2011; 69, 6: 566&#8211;571Wstęp: Wiadomo, że jawna cukrzyca i jawna hiperglikemia mogą sprzyjać wystąpieniu migotania przedsionków. Cel: Celem pracy była zbadanie dyspersji załamka P (PWD) jako metody oceny heterogenności opornosci przedsionków u chorych ze stanem przedcukrzycowym. Metody: Na podstawie poniższych wyników do badania włączono 84 chorych ze stanem przedcukrzycowym (grupa pre- DM: 50 kobiet, 34 mężczyzn; średni wiek 54 &#177; 8,6 roku) bez jawnej cukrzycy, choroby wieńcowej czy nadciśnienia, u których stężenie glukozy na czczo wynosiło ponad 100 mg/dl i/lub u których stężenia glukozy po 2 h podczas testu doustnego obciążenia glukozą znajdowały się w zakresie 140&#8211;199 mg/dl, oraz 48 zdrowych ochotników (grupa non-DM: 30 kobiet, 18 mężczyzn, średni wiek 51,7 &#177; 7,3 roku) bez rozpoznanych chorób. Standardowy 12-odprowadzeniowy elektrokardiogram wykonano u wszystkich badanych przy standardowym przesuwie taśmy 50 mm/s z cechą 20 mm/mV. Zmierzono maksymalne (Pmax) i minimalne (Pmin) czasy trwania załamków P, a PWD zdefiniowano jako różnicę między Pmax i Pmin. Wyniki: Wartości Pmax oraz PWD były istotnie wyższe w grupie pre-DM w porównaniu z non-DM (odpowiednio 104 &#177; 13 ms v. 98 &#177; 12 ms; p < 0,05; 42 &#177; 13 ms v. 34 &#177; 11 ms; p < 0,01). Stwierdzono dodatnią korelację między PWD i stężeniem glukozy na czczo (r = 0,32; p 0,05). Wieloczynnikowa analiza regresji nie wykazała związku między PWD a wiekiem, wymiarem lewego przedsionka, wartościami E, A, E/A oraz HbA1c. Stwierdzono jednak zależność między PWD i stężeniem glukozy na czczo. Wnioski: Wartości Pmax oraz PWD mogą być zwiększone u osób ze stanem przedcukrzycowym bez rozpoznanej choroby wieńcowej, nadciśnienia czy przerostu lewej komory. Kardiol Pol 2011; 69, 6: 566&#8211;57

Assessment of QRS duration and presence of fragmented QRS in patients with Behcet's disease

WOS: 000323225700010PubMed: 23612364Background QRS prolongation and the presence of QRS fragmentation in 12-lead ECG are associated with increased mortality and sudden cardiac death in the long term. In this study we aimed to assess QRS duration and fragmentation in patients with Behcet's disease (BD).Methods A total of 50 patients (mean age 42.7 +/- 12.0 years) previously diagnosed with BD were recruited. In addition, a control group consisting of 50 healthy people (mean age 39.4 +/- 12.5 years) was formed. The longest QRS duration was measured in surface 12-lead ECG and QRS complexes were evaluated in terms of fragmentation. Serum C-reactive protein levels were also obtained.Results QRS duration and corrected QT duration were significantly longer in patients with BD compared with controls (102.75 +/- 11.91 vs. 96.99 +/- 10.91 ms, P=0.007; 438.55 +/- 30.80 vs. 420.23 +/- 28.06 ms, P=0.003, respectively). Fragmented QRS (fQRS) pattern was more common in patients with BD than controls [n=27 (54%) vs. n=16 (32%), P=0.026]. Disease duration was longer in patients with BD with fQRS compared with those without (12.67 +/- 8.68 vs. 7.09 +/- 7.06 years, P=0.010). Furthermore, C-reactive protein level was higher in patients with BD with fQRS compared with those without (6.53 +/- 4.11 vs. 4.97 +/- 6.32 mg/dl, P=0.043). Correlation analysis revealed no association between disease duration and QRS duration (r=0.219, P=0.126).Conclusion QRS duration is greater and fQRS complexes are more frequent in patients with BD. These findings may indicate subclinical cardiac involvement in BD. Given the prognostic significance of ECG parameters, it is reasonable to evaluate patients with BD with prolonged and fQRS complexes more in detail such as late potentials in signal averaged ECG in terms of cardiac involvement