title: Evaluation of atrial electromechanical delay and its relationship to inflammation and oxidative stress in patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  The aims of this study were to evaluate atrial electromechanical delay, inflammation, and oxidative stress parameters, along with to investigate clinical and laboratory characteristics affecting atrial electromechanical delay in patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Forty-three patients with COPD (60.5 ± 9.9 years) and 50 healthy controls (59.6 ± 7.1 years) were included in the study. Atrial electromechanical delay intervals were measured from lateral mitral annulus corrected PA (cPA lateral) and lateral tricuspid annulus (cPA tricuspid) using tissue Doppler imaging (TDI), and corrected for heart rate. Left and right ventricles functions were examined using conventional and TDI. Plasma levels of high-sensitive C-reactive protein (hsCRP) and oxidative stress parameters were also measured. Factors associated with atrial electromechanical delay were evaluated by stepwise multiple regression analysis.
  
  
  RESULTS
  Corrected PA lateral and cPA tricuspid were significantly higher in patients with COPD (69.8 ± 10.4 vs. 62.2 ± 8.9 msec, P < 0.001 and 45.4 ± 10.2 vs. 33.5 ± 5.1 msec, P < 0.001, respectively). Plasma levels of hsCRP and malondialdehyde, an indicator of oxidative stress, were increased in patient's group (15.7 ± 31.7 vs. 4.8 ± 4.7 mg/L, P = 0.01 and 17.1 ± 10.3 vs. 11.6 ± 7.9 nmol/L, P = 0.005, respectively). cPA lateral is independently related to lateral Em /Am ratio (β = -0.29, P = 0.004) and forced expiratory volume in 1st second/forced vital capacity (FEV1 /FVC) ratio (β = -0.24, P = 0.02). cPA tricuspid is independently related to only FEV1 /FVC ratio (β = -0.51, P < 0.001).
  
  
  CONCLUSIONS
  This study shows that atrial electromechanical delay intervals are prolonged in patients with COPD. Prolongation of atrial electromechanical delay measured from lateral tricuspid annulus was independently related with FEV1 /FVC ratio in these patients.
authors.affiliation: Department of Cardiology, Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey.
authors.forename: Gurkan
authors.initials: G
authors.lastname: Acar
authors.forename: Hasan
authors.initials: H
authors.lastname: Kahraman
authors.forename: Murat
authors.initials: M
authors.lastname: Akkoyun
authors.forename: Metin
authors.initials: M
authors.lastname: Kilinc
authors.forename: Cemil
authors.initials: C
authors.lastname: Zencir
authors.forename: Edagani
authors.initials: E
authors.lastname: Yusufoglu
authors.forename: Imran
authors.initials: I
authors.lastname: Dirnak
authors.forename: Hatice
authors.initials: H
authors.lastname: Sahin
authors.forename: Soner
authors.initials: S
authors.lastname: Olmez
authors.forename: Ahmet
authors.initials: A
authors.lastname: Akcay
authors.forename: Idris
authors.initials: I
authors.lastname: Ardic
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism*; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013147:Spirometry
chemical_list: D002097:C-Reactive Protein
keywords: atrial electromechanical delay; chronic obstructive pulmonary disease; inflammation; oxidative stress