title: Assessment of atrial electromechanical delay by tissue Doppler echocardiography in patients with nonischemic dilated cardiomyopathy.
abstract: BACKGROUND
  Atrial electromechanical delay (AEMD) calculated from tissue Doppler imaging (TDI) echocardiography can be an alternative to invasive electrophysiologic studies. We investigated whether the AEMD obtained from TDI is prolonged in patients with nonischemic dilated cardiomyopathy (DCM).
  
  
  METHODS
  Fifty-five patients with nonischemic DCM (23 men/32 women; age, 43.9 +/- 14.8 years) and 55 controls (20 men/35 women; age, 41.3 +/- 13.4 years) were included in this study. Atrial electromechanical delay (the time interval from the onset of P wave on electrocardiogram to the beginning of late diastolic wave [Am wave] on TDI) was calculated from the lateral and septal mitral annulus, and lateral tricuspid annulus (PA lateral, PA septum, and PA tricuspid, respectively). P-wave dispersion was calculated from the 12-lead electrocardiogram.
  
  
  RESULTS
  PA lateral and PA septum duration were significantly longer in patients with nonischemic DCM than the controls (78.4 +/- 19.7 versus 53.8 +/- 6.6 and 55.2 +/- 16.3 versus 40.5 +/- 6.2, P < .0001 for both; respectively). However, PA tricuspid duration was statistically similar between the 2 groups (36.4 +/- 10.9 versus 37.2 +/- 5.7, P > or = .05). P-wave dispersion was significantly higher in nonischemic DCM patients than the controls (53.0 +/- 14.4 versus 37.5 +/- 5.5, P < .0001). PA lateral was correlated with the left atrial maximal volume (r = 0.64, P < .0001), P-wave dispersion (r = 0.65, P < .0001), and log B-type natriuretic peptide (NT proBNP) (r = 0.63, P < .0001). There was a statistically significant and negative correlation between the PA lateral and left ventricular ejection fraction (r = -0.63, P < .0001) and E-wave deceleration time (r = -0.34, P < .0001). Multivariate analysis revealed that left atrial maximal volume and log NT proBNP were the independent predictors of PA lateral (P < .0001 and P = .003, respectively).
  
  
  CONCLUSIONS
  The AEMD was significantly prolonged in patients with nonischemic DCM. Left atrial enlargement and log NT proBNP were the independent predictors of this prolongation.
authors.affiliation: Cardiology Division, Kartal Kosuyou Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Pala
authors.forename: Kursat
authors.initials: K
authors.lastname: Tigen
authors.forename: Tansu
authors.initials: T
authors.lastname: Karaahmet
authors.forename: Cihan
authors.initials: C
authors.lastname: Dundar
authors.forename: Alev
authors.initials: A
authors.lastname: Kilicgedik
authors.forename: Ahmet
authors.initials: A
authors.lastname: Güler
authors.forename: Cihan
authors.initials: C
authors.lastname: Cevik
authors.forename: Cevat
authors.initials: C
authors.lastname: Kirma
authors.forename: Yelda
authors.initials: Y
authors.lastname: Basaran
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000503:physiopathology*; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006329:Heart Conduction System / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity