title: Assessment of ventricular and left atrial mechanical functions, atrial electromechanical delay and P wave dispersion in patients with scleroderma.
abstract: BACKGROUND
  The aim of this study was to investigate ventricular functions and left atrial (LA) mechanical functions, atrial electromechanical coupling, and P wave dispersion in scleroderma patients.
  
  
  METHODS
  Twenty-six patients with scleroderma and twenty-four controls were included. Left and right ventricular (LV and RV) functions were evaluated using conventional echocardiography and tissue Doppler imaging (TDI). LA volumes were measured using the biplane area- -length method and LA mechanical function parameters were calculated. Inter-intraatrial electromechanical delays were measured by TDI. P wave dispersion was calculated by 12-lead electrocardiograms.
  
  
  RESULTS
  LV myocardial performance indices (MPI) and RV MPI were higher in patients with scleroderma (p = 0.000, p = 0.000, respectively) while LA passive emptying fraction was decreased and LA active emptying fraction was increased (p = 0.051, p = 0.000, respectively). P wave dispersion and inter-intraatrial electromechanical delay were significantly higher in patients with scleroderma (25 [10-60] vs 20 [0-30], p = 0.000, 16.50 [7.28-26.38] vs 9.44 [3.79-15.78] and 11.33 [4.88-16.06] vs 4.00 [0-12.90], p < 0.05, respectively). Interatrial electromechanical delay was negatively correlated with LV E wave, (p = 0.018). LV E wave was demonstrated to be a factor independent of the interatrial electromechanical delay (R² = = 0.270, b = -0.52, p = 0.013).
  
  
  CONCLUSIONS
  This study showed that in scleroderma patients, global functions of LV, RV and mechanical functions of LA were impaired, intra-interatrial electromechanical delays were prolonged and P wave dispersion was higher. LV E wave was demonstrated to be a factor that is independent of the interatrial electromechanical delay. Reduced LV E wave may also give additional information on the process of risk stratification of atrial fibrillation.
authors.affiliation: Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey. meryemaktoz1@yahoo.com
authors.forename: Meryem
authors.initials: M
authors.lastname: Aktoz
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yilmaztepe
authors.forename: Ersan
authors.initials: E
authors.lastname: Tatli
authors.forename: Fatma Nesrin
authors.initials: FN
authors.lastname: Turan
authors.forename: Elif G
authors.initials: EG
authors.lastname: Umit
authors.forename: Armagan
authors.initials: A
authors.lastname: Altun
mesh_terms: D000328:Adult; D000368:Aged; D016279:Atrial Function, Left / Q000502:physiology; D016280:Atrial Function, Right / Q000502:physiology; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000502:physiology; D006331:Heart Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D006334:Heart Function Tests; D006351:Heart Valves / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D012595:Scleroderma, Systemic / Q000150:complications / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology; D016278:Ventricular Function, Right / Q000502:physiology; D055815:Young Adult