title: P-wave dispersion and its relationship to aortic stiffness in patients with acute myocardial infarction after cardiac rehabilitation.
abstract: BACKGROUND
  The aim of our study was to investigate the P-wave dispersion from standard electrocardiograms (ECGs) in patients with acute myocardial infarction (AMI) after cardiac rehabilitation (CR) and determine its relation to arterial stiffness.
  
  
  METHODS
  This is a prospective study included 33 patients with AMI and successfully re-vascularized by percutaneous coronary intervention (PCI) underwent CR. Left ventricular ejection fraction (LVEF) was measured by biplane Simpson's method. Left atrium (LA) volume was calculated. The maximum and minimum durations of P-waves (Pmax and Pmin, respectively) were detected, and the difference between Pmax and Pmin was defined as P-wave dispersion (Pd = Pmax-Pmin). Aortic elasticity parameters were measured.
  
  
  RESULTS
  LVEF was better after CR. The systolic and diastolic blood pressures decreased after CR, these differences were statistically significant. With exercise training, LA volume decreased significantly. Pmax and Pd values were significantly shorter after the CR program. The maximum and minimum P-waves and P-wave dispersion after CR were 97 ± 6 ms, 53 ± 5 ms, and 44 ± 5 ms, respectively. Aortic strain and distensibility increased and aortic stiffness index was decreased significantly. Aortic stiffness index was 0.4 ± 0.2 versus 0.3 ± 0.2, P = 0.001. Aortic stiffness and left atrial volume showed a moderate positive correlation with P-wave dispersion (r = 0.52, P = 0.005; r = 0.64, P < 0.001, respectively).
  
  
  CONCLUSIONS
  This study showed decreased arterial stiffness indexes in AMI patient's participated CR, with a significant relationship between the electromechanical properties of the LA that may raise a question of the preventive effect of CR from atrial fibrillation and stroke in patients with acute myocardial infarction.
authors.affiliation: Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.
authors.forename: Rezzan Deniz
authors.initials: RD
authors.lastname: Acar
authors.affiliation: Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bulut
authors.affiliation: Department of Physical Therapy and Rehabilitation, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.
authors.forename: Sunay
authors.initials: S
authors.lastname: Ergün
authors.affiliation: Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Yesin
authors.affiliation: Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.
authors.forename: Bilal
authors.initials: B
authors.lastname: Boztosun
authors.affiliation: Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akçakoyun
keywords: Acute Myocardial Infarction; Aortic Stiffness; Cardiac Rehabilitation; P-Wave Dispersion