title: Assessment of atrial electromechanical delay and influential factors in patients with obstructive sleep apnea.
abstract: OBJECTIVE
  The interaction between moderate-to-severe obstructive sleep apnea (OSA) and cardiac arrhythmias, especially atrial fibrillation (AF), is well known. We aimed to determine whether atrial electromechanical parameters assessed by tissue Doppler imaging (TDI) would be affected in moderate-to-severe OSA, and detect the influential factors of atrial electromechanical parameters in these patients.
  
  
  RESULTS
  Interatrial and intra-atrial electromechanical delay was measured by TDI in patients with moderate-to-severe OSA (n = 64) and control subjects (n = 39). P-wave dispersion (PWD) was calculated on the 12-lead ECG. Interatrial and intra-atrial electromechanical delay was significantly higher in the OSA group when compared with the controls (52.26 ± 12.9 vs 29.61 ± 11.26, P < 0.0001 and 18.90 ± 8.13 vs 8.71 ± 5.46, P < 0.0001; respectively). PWD was higher in the OSA group (46.09 ± 13.40 ms vs 34.10 ± 10.75 ms, P < 0.0001). Interatrial electromechanical delay had a positive correlation with PWD (r = 0.490, P < 0.0001), left atrial (LA) diameter (r = 0.383, P = 0.002), LA volume index (r = 0.354, P = 0.004), and apnea-hypopnea index (r = 0.365, P = 0.003). In addition, interatrial electromechanical delay was negatively correlated with the magnitude of the lowest oxygen saturation percentage (r = -0.498, P < 0.0001).
  
  
  CONCLUSIONS
  This study showed that interatrial and intra-atrial electromechanical delay and PWD were prolonged in patients with moderate-to-severe OSA. LA dilatation, hypoxemia, and the severity of the disease may contribute a prolongation in interatrial electromechanical delay via atrial structural and electrical alterations, which may predict the risk of future AF development in patients with moderate-to-severe OSA.
authors.affiliation: Faculty of Medicine, Department of Cardiology, Inonu University, Malatya, Turkey. julideyagmur@hotmail.com
authors.forename: Julide
authors.initials: J
authors.lastname: Yagmur
authors.forename: Ozkan
authors.initials: O
authors.lastname: Yetkin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Cansel
authors.forename: Nusret
authors.initials: N
authors.lastname: Acikgoz
authors.forename: Necip
authors.initials: N
authors.lastname: Ermis
authors.forename: Yasin
authors.initials: Y
authors.lastname: Karakus
authors.forename: Hakan
authors.initials: H
authors.lastname: Tasolar
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D012016:Reference Values; D012307:Risk Factors; D012815:Signal Processing, Computer-Assisted; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology*
chemical_list: D010100:Oxygen