Assessment of atrial electromechanical coupling characteristics in patients with ankylosing spondylitis.
OBJECTIVE
The aim of this study was to evaluate atrial conduction abnormalities obtained by Doppler tissue imaging (DTI) and electrocardiogram analysis in ankylosing spondylitis (AS) patients.


METHODS
A total of 40 patients with AS (22 males /18 females, 37.82 +/- 10.22 years), and 42 controls (22 males/20 females, 35.74 +/- 9.98 years) were included. Systolic and diastolic left ventricular (LV) functions were measured by using conventional echocardiography and DTI. Interatrial and intraatrial electromechanical coupling (PA) intervals were measured with DTI. P-wave dispersion (PD) was calculated from the 12-lead electrocardiogram.


RESULTS
Atrial electromechanical coupling at the left lateral mitral annulus (PA lateral) was significantly delayed in AS patients (61.65 +/- 7.81 vs 53.69 +/- 6.75 ms, P < 0.0001). Interatrial (PA lateral - PA tricuspid), intraatrial electromechanical coupling intervals (PA septum - PA tricuspid), maximum P-wave (Pmax) duration, and PD were significantly longer in AS patients (23.50 +/- 7.08 vs 14.76 +/- 5.69 ms, P < 0.0001; 5.08 +/- 5.24 vs 2.12 +/- 2.09 ms, P = 0.001; 103.85 +/- 6.10 vs 97.52 +/- 6.79 ms, P < 0.0001; and 48.65 +/- 6.17 vs 40.98 +/- 5.37 ms, P < 0.0001, respectively). Reflecting LV diastolic function mitral A-wave and E/A, mitral E-wave deceleration time (DT), Am and Em/Am were significantly different between the groups (P < 0.05). We found a significant correlation between interatrial electromechanical coupling interval with PD (r = 0.536, P < 0.01). Interatrial electromechanical coupling interval was positively correlated with DT (r = 0.422, P < 0.01) and inversely correlated with E/A (r =-0.263, P < 0.05) and Em/Am (r =-0.263, P < 0.05).


CONCLUSIONS
This study shows that atrial electromechanical coupling intervals and PD are delayed, and LV diastolic functions are impaired in AS patients.
Department of Cardiology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey. gurkandracar@hotmail.com
Gurkan
G
Acar
Mehmet
M
Sayarlioglu
Ahmet
A
Akcay
Abdullah
A
Sokmen
Gulizar
G
Sokmen
Burak
B
Altun
Alper Bugra
AB
Nacar
Mehmet
M
Gunduz
Cemal
C
Tuncer
D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*