Increased P wave dispersion in patients with liver steatosis.
OBJECTIVE
Hepatic steatosis is associated with metabolic and hemodynamic abnormalities induced by insulin resistance and inflammatory state. Since abnormalities of P wave dispersion may be accompanied with latter issues we evaluated this subject in patients with hepatic steatosis.


METHODS
Total of 106 patients and 56 healthy subjects were enrolled and performed hepatic ultrasonography, echocardiography, electrocardiogram, and biochemistry tests. Clinical features, laboratory and echocardiographic parameters, P wave dispersion were compared between groups and analyzed for any correlation among parameters.


RESULTS
Body mass index (BMI), waist circumference, systolic and diastolic blood pressure, levels of total and LDL cholesterol, and fasting blood glucose (FBG), and left atrial diameter were significantly higher in patients with hepatic steatosis. Peak velocities of mitral E and A waves and their ratio were abnormally changed in patients compared to normals. In multiple linear regression analysis, approximately all of the variables previously correlated within Pearsons' correlation test were found to be significantly correlated with P wave dispersion [ waist circumference (ß=0.151, p=0.048), LDL cholesterol (ß=0.234, p=0.000), FBG (ß=0.402, p= 0.000), alanine aminotransferase (ALT) (ß=0.205, p= 0.006), alkaline phosphatase (ALP) (ß=0.277, p=0.000), γ-glutamyl transferase (γ-GT) (ß=0.240, p=0.000), left atrial diameter (ß=0.204, p=0.003), heart rate (ß=0.123, p=0.037)].


CONCLUSIONS
Increased P wave dispersion may indicate a risk of atrial arrhythmia which may be complicated with disabling symptoms and thromboembolism in patients with hepatic steatosis. Consequently, hepatic steatosis is associated with increased risk for cardiovascular disease due to metabolic and hemodynamic abnormalities probably induced by insulin resistance and inflammaory state.
Air Force Academy Hospital, Cardiology Service, Istanbul. maparci@gmail.com
Mustafa
M
Aparci
Zafer
Z
Isilak
Omer
O
Uz
Ejder
E
Kardesoglu
Omer
O
Yiginer
Onur
O
Sildiroglu
Murat
M
Yalcin
Namık
N
Ozmen
Bekir Yilmaz
BY
Cingozbay
Bekir Sitki
BS
Cebeci
D000328:Adult; D015992:Body Mass Index; D004452:Echocardiography; D004562:Electrocardiography; D005234:Fatty Liver / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate; D006801:Humans; D007333:Insulin Resistance; D008297:Male