Assessment of Left Atrial Function in Patients with Celiac Disease.
BACKGROUND
There is some evidence suggesting increased risk of atrial fibrillation (AF) in patients with celiac disease (CD). Impaired left atrial function plays a significant role in the development of AF. This study aimed at assessing the electrical and mechanical functions of the left atrium in patients with CD.


METHODS
A total of 71 patients with biopsy-proven, antibody-positive CD and 52 age-matched healthy controls were included in this prospective study. P-wave dispersion (PWD) was measured to assess the electrical functions of the left atrium through the use of surface electrocardiography. A tissue Doppler echocardiography was performed to determine the atrial conduction and electromechanical delay (EMD) time. To evaluate the mechanical functions of the left atrium, maximum, minimum, and presystolic atrial volumes were estimated to calculate the contractile, conduit, and reservoir functions.


RESULTS
In terms of transthoracic echocardiographic parameters, CD and control subjects were not significantly different. However, as compared to controls, patients with CD had significantly increased PWD (median 52 ms [interquartile range 46-58 ms] vs. 38 [36-40], P < 0.001). Also, significantly higher interatrial (49 ms [32-60] vs. 26 ms [22-28], P < 0.001), intra-left atrial (26 ms [17-44] vs. 14 ms [12-18], P < 0.001), and intra-right atrial (15 ms [8-22] vs. 10 ms [8-14], P < 0.001) EMD was found among CD subjects than controls. Despite an increase in the left atrial volume in patients with CD, conduit and reservoir functions were comparable.


CONCLUSIONS
Although atrial mechanical functions are preserved in patients with CD, a slower electrical conduction was found, suggesting an increased risk of AF in this group of patients.
Cardiology Department, Antalya Education and Research Hospital, Antalya, Turkey.
Nermin
N
Bayar
Gastroenterology Department, Antalya Education and Research Hospital, Antalya, Turkey.
Ayhan Hilmi
AH
Çekin
Cardiology Department, Antalya Education and Research Hospital, Antalya, Turkey.
Şakir
Ş
Arslan
Cardiology Department, Antalya Education and Research Hospital, Antalya, Turkey.
Göksel
G
Çağırcı
Cardiology Department, Antalya Education and Research Hospital, Antalya, Turkey.
Zehra
Z
Erkal
Cardiology Department, Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.
Serkan
S
Çay
Cardiology Department, Antalya Education and Research Hospital, Antalya, Turkey.
Erkan
E
Köklü
Cardiology Department, Antalya Education and Research Hospital, Antalya, Turkey.
Selçuk
S
Küçükseymen
D000328:Adult; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D016279:Atrial Function, Left; D002446:Celiac Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
P-wave dispersion; atrial fibrillation; celiac disease; echocardiography; left atrial function