title: Assessment of atrial electromechanical delay in patients with migraine.
abstract: Evidence suggests that symptoms of migraine are related to the involvement of the autonomic nervous system. Data on atrial conduction system are limited in migraineurs. We aimed to assess atrial electromechanical delay using tissue Doppler imaging (TDI) in patients with migraine. Forty-five migraine patients and age- and sex-matched 26 control subjects were enrolled in the study. All the patients and controls underwent resting surface electrocardiogram (ECG) and TDI. The maximum P-wave duration (Pmax), minimum P-wave duration (Pmin) and P-wave dispersion (Pd) were measured from the 12-lead ECG. Atrial conduction time was determined from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septal), and lateral tricuspid annulus (PA tricuspid) by TDI. Interatrial (PA lateral-PA tricuspid) and intraatrial (PA septal-PA tricuspid) electromechanical delays were calculated. Pd was significantly higher in migraine patients than in controls (p < 0.05), whereas Pmax and Pmin were not different between both groups (p > 0.05). PA lateral and PA septal durations were significantly higher in migraine patients than in controls (p < 0.001 and p < 0.05, respectively). However, PA tricuspid duration was similar between the groups (p > 0.05). Both interatrial and intraatrial conduction times were delayed in migraineurs as compared to the controls (p < 0.001). Interatrial delay and intraatrial delay variables were found as an independent risk factors separately on predicting atrial conduction abnormalities in migraineurs. An interatrial delay of 18 ms and an intraatrial delay of 5 ms were found to be cutoff values in ROC analysis (p < 0.001). This is the first report to provide a hypothetical suggestion that there is an atrial electromechanical delay in patients with migraine.
authors.affiliation: Department of Neurology, Medical School, Bozok University, Yozgat, 66200, Turkey, asunebioglu@yahoo.com.
authors.forename: Asuman
authors.initials: A
authors.lastname: Celikbilek
authors.forename: Savas
authors.initials: S
authors.lastname: Sarikaya
authors.forename: Gokmen
authors.initials: G
authors.lastname: Zararsiz
authors.forename: Nermin
authors.initials: N
authors.lastname: Tanik
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Erbay
mesh_terms: D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac; D001794:Blood Pressure / Q000502:physiology; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications* / Q000209:etiology*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D055815:Young Adult