title: Assessment of atrial electromechanical coupling and influential factors in nonrheumatic paroxysmal atrial fibrillation.
abstract: BACKGROUND
  Sequential analysis of atrial electromechanical coupling (P-A) by Doppler tissue imaging (DTI) might provide important insight into the mechanisms of paroxysmal atrial fibrillation (PAF).
  
  
  OBJECTIVE
  The purpose of this study was to evaluate P-A and the dispersion of P-A, and to analyze the influential factors of P-A.
  
  
  METHODS
  One hundred and ten patients with PAF and 87 normal controls were enrolled. Using DTI, the time intervals from the beginning of P-wave to the onset of atrioventricular ring motion related to atrial contraction were measured.
  
  
  RESULTS
  Atrial electromechanical coupling at the interventricular septum atrioventricular annulus (P-A1), left lateral mitral annulus (P-A2) and right lateral tricuspid annulus (P-A3) in PAF group were significantly longer than those in control (p < 0.001). The difference between P-A2 and P-A1 (T1), P-A2 and P-A3 (T3) in PAF group were greater than those in control before age correction (p < 0.05). The linear regression analysis showed that the duration of PAF episodes and age were the greatest influential factors of P-A1 (r = 0.564). Left atrial anterior-posterior dimension (LAD) and age were the greatest influential factors of P-A2 (r = 0.459). The LAD was the greatest influential factors of T1 and T3 (r = 0.408, 0.542).
  
  
  CONCLUSIONS
  The atrial electromechanical coupling was significantly longer and the dispersion of P-A at left lateral mitral annulus was greater in PAF patients. The prolongation of P-A may be related to left atrial enlargement, long episodes of PAF and aging and the dispersion of P-A at left lateral mitral annulus to LAD.
authors.affiliation: Department of Echocardiography, FuWai Cardiovascular Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, 167 Beilishi Road, Beijing, China. whcqq@yahoo.com.cn
authors.forename: Qi-Qiong
authors.initials: QQ
authors.lastname: Cui
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Hu
authors.initials: H
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Sun
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.forename: Huan-Yi
authors.initials: HY
authors.lastname: Yang
authors.forename: Xian-Qiang
authors.initials: XQ
authors.lastname: Meng
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology; D006346:Heart Septum / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D014261:Tricuspid Valve / Q000473:pathology; D014463:Ultrasonography