title: Determinants of Atrial Electromechanical Delay in Patients with Functional Mitral Regurgitation and Non-ischemic Dilated Cardiomyopathy.
abstract: BACKGROUND
  Atrial conduction time has important hemodynamic effects on ventricular filling and is accepted as a predictor of atrial fibrillation. In this study we assessed atrial conduction time in patients with non ischemic dilated cardiomyopathy (NIDCMP) and functional mitral regurgitation (MR) and aimed to determine factors predicting atrial conduction time prolongation.
  
  
  METHODS
  Sixty five patients with non ischemic dilated cardiomyopathy who have moderate to severe MR and 60 control subjects were included in the study. In addition to conventional echocardiographic measures used to asses left ventricle and MR, atrial electromechanical coupling (time interval from the onset of P wave on surface electrocardiogram [ECG] to the beginning of A wave interval with tissue Doppler echocardiography [PA]), intra- and interatrial electromechanical delay (intra and inter AEMD) were measured.
  
  
  RESULTS
  The correlations between inter AEMD and left atrial (LA) size, MR volume, isovolumetric relaxation time (IVRT), deceleration time (DT), systolic pulmonary artery pressure (PAPs), E/A ratio and E/e' were very poor. Similarly, intra AEMD was not correlated to LA size , MR volume, IVRT, DT, PAPs, E/A ratio and E/e'. However, both inter AEMD and intra AEMD had good correlation with left ventricular mass index, tenting area (TA), tenting distance (TD), coaptation septal distance (CSD), sphericity index (SI).
  
  
  CONCLUSIONS
  Prolongation of inter and intra AEMDs were found to be well correlated with parameters reflecting left ventricular and mitral annular remodeling.
authors.affiliation: Kartal Kosuyolu Heart Education and Research Hospital, Cardiology Department, Istanbul, Turkey.
authors.forename: Ruken
authors.initials: R
authors.lastname: Bengi Bakal
authors.affiliation: Kartal Kosuyolu Heart Education and Research Hospital, Cardiology Department, Istanbul, Turkey.
authors.forename: Suzan
authors.initials: S
authors.lastname: Hatipoglu
authors.affiliation: Kartal Kosuyolu Heart Education and Research Hospital, Cardiology Department, Istanbul, Turkey.
authors.forename: Muslum
authors.initials: M
authors.lastname: Sahin
authors.affiliation: Kartal Kosuyolu Heart Education and Research Hospital, Cardiology Department, Istanbul, Turkey.
authors.forename: Mehmet Yunus
authors.initials: MY
authors.lastname: Emiroglu
authors.affiliation: Kartal Kosuyolu Heart Education and Research Hospital, Cardiology Department, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bulut
authors.affiliation: Kartal Kosuyolu Heart Education and Research Hospital, Cardiology Department, Istanbul, Turkey.
authors.forename: Nihal
authors.initials: N
authors.lastname: Ozdemir
keywords: Atrial Electromechanical Delay; Functional Mitral Regurgitation; Non-Ischemic Dilated Cardiomyopathy