title: Evaluation of atrial electromechanical conduction delay in case of hemodynamically insignificant rheumatic heart disease: A tissue Doppler study.
abstract: BACKGROUND
  Atrial electromechanical delay (AEMD) that reflects delayed conduction may show us the clinical reflection of pathological changes in the atria. The main objective of the present study is to investigate AEMD in patients who had previous rheumatic carditis but without hemodynamically significant valvular disease.
  
  
  METHODS
  A total of 40 patients, previously diagnosed as rheumatic carditis but without significant valvular stenosis/regurgitation and atrial enlargement; and 39 age- and-sex matched controls were enrolled for the present study. Parameters of AEMD (lateral mitral annulus electromechanical delay, septal mitral annulus electromechanical delay and lateral tricuspid annulus electromechanical delay) were measured with tissue Doppler echocardiography and left intra-atrial and inter-atrial conduction times were calculated accordingly. A 24h ambulatory Holter monitoring was used in both groups to detect atrial fibrillation episodes and quantify atrial extrasystoles.
  
  
  RESULTS
  Parameters of AEMD, including left intra-atrial and inter-atrial conduction times of subjects in the study group were longer compared to the control group (23.7 ± 7.0 vs. 18.3 ± 6.2).
  
  
  CONCLUSIONS
  Increased AEMD is observed in patients with previous rheumatic carditis and no significant valvular stenosis/regurgitation and atrial enlargement, which may partly explain the increased incidence of atrial fibrillation observed in these patients.
authors.forename: Metin
authors.initials: M
authors.lastname: Cagdas
authors.affiliation: Department of Cardiology, Training and Research Hospital, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey. dr_yalchin_dr@yahoo.com.tr.
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Velibey
authors.forename: Tolga Sinan
authors.initials: TS
authors.lastname: Guvenc
authors.forename: Baris
authors.initials: B
authors.lastname: Gungor
authors.forename: Ozge
authors.initials: O
authors.lastname: Guzelburc
authors.forename: Nazmi
authors.initials: N
authors.lastname: Calik
authors.forename: Murat
authors.initials: M
authors.lastname: Ugur
authors.forename: Ahmet Ilker
authors.initials: AI
authors.lastname: Tekkesin
authors.forename: Kadir
authors.initials: K
authors.lastname: Gurkan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eren
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000379:methods*; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013997:Time Factors
keywords: atrial electromechanical conduction delay; echocardiography; hemodynamically insignificant rheumatic heart disease